Means of vascular access are fundamental in the management of cancer. However, since current intravenous devices for long-term treatment are expensive and necessitate a high degree of education among medical personnel, in developing countries they are impractical for use in most of the population. We describe the use of a nontunneled, low-cost, long-lasting Silastic catheter (LLSC), cared for by an intravenous therapy team (IVTT), in 462 patients with cancer. The rate of infectious complications was 0.66 infections per 1,000 catheter-days, which is as low as that reported in association with other catheters in developed countries. Neutropenia and skin and/or soft-tissue infections were significant risk factors associated with LLSC-related infections. We believe that use of this catheter may be an alternative for patients with cancer who need chemotherapy, as long as an IVTT is established for its care. Our experience could be useful for practitioners in countries with similar socioeconomic characteristics.

Summary:fusion of PBSC and the i. -106). The incidence of infectiousWe present our experience at the Instituto Nacional de Cancerología in Mexico, with the installation and care of complications was 2.2 ؋ 1000 catheter-days (1.7 Permacath and 3.0 Mahurkar); during neutropenia it was an IVTT including apheresis collection, reinfusion of PBSC and intravenous and hematological support of patients 3.7 ؋ 1000 cathether-days. The incidence of thrombosis was 0.9 ؋ 1000 catheter-days. There was a total of seven undergoing PBSCT in whom a high-flow catheter (Mahurkar or Permacath) was installed between November infectious episodes (12.7%). Five (9%) were local and two were (3.6%) bacteremias. The microorganism most 1992 and June 1994. commonly isolated was Staphylococcus sp. (57%). Four catheters (7.1%) were removed because of complications: one thrombosis and three infections. Both cathMaterials and methods eters have proven useful and safe for long-lasting vascular access in patients undergoing PBSCT. No statistical Catheter difference was found in infectious and non-infectiousThe devices utilized were either a Mahurkar (Quinton complications between either catheters.Instrument, Seattle, WA, USA) double lumen nontunneled Keywords: peripheral blood stem cell transplantation; siliconized catheter or a Permacath (Quinton Instrument) apheresis catheters; intravenous therapy team silastic, double lumen, Dacron felt cuff tunneled catheter. Both catheters are imported to Mexico, and the choice of which one to place in a patient was based solely on availPeripheral blood stem cell transplantation (PBSCT) is a ability. new therapeutic approach for supporting treatment with high-dose chemotherapy.

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