Central venous device‐related infection and thrombosis in patients treated with moderate dose continuous‐infusion interleukin‐2
BACKGROUND This study was performed to determine the incidence of central venous device‐related blood stream infection and thrombosis in patients treated with moderate dose continuous‐infusion interleukin‐2 (IL‐2). METHODS The records of 160 consecutive patients treated at the University of Wisconsi...
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| Veröffentlicht in: | Cancer 2001-02, Vol.91 (4), p.806-814 |
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| creator | Eastman, Michael E. Khorsand, Masoud Maki, Dennis G. Williams, Eliot C. Kim, KyungMann Sondel, Paul M. Schiller, Joan H. Albertini, Mark R. |
| description | BACKGROUND
This study was performed to determine the incidence of central venous device‐related blood stream infection and thrombosis in patients treated with moderate dose continuous‐infusion interleukin‐2 (IL‐2).
METHODS
The records of 160 consecutive patients treated at the University of Wisconsin Hospital and Clinics, between June 1990 and June 1997, with moderate dose continuous‐infusion IL‐2 (IL‐2 [1.5–3.0 × 106 U/m2/day] Hoffman‐LaRoche, Nutley, NJ or IL‐2 [4.5 × 106 U/m2/day] Chiron Corporation, Berkley, CA) were reviewed retrospectively. The majority of patients had metastatic melanoma (78 patients) or renal cell carcinoma (70 patients). All of the patients had a surgically implanted central venous device placed before starting IL‐2 therapy; 89% of these were cuffed Hickman catheters. Eighty‐four patients received 1 mg of warfarin per day as prophylaxis against device‐related thrombosis; none received periinsertion prophylactic antibiotics.
RESULTS
Twenty‐one patients (13%) developed central venous device‐related bloodstream infection (DRBSI) during the study period, a rate of 2 DRBSI per 1000 device‐days. DRBSIs were associated with the type of immunotherapy given with IL‐2 (P = 0.01) and with thrombosis (odds ratio, 4.1; 95% confidence interval, 1.5–11.4; P = 0.008) but not with patient gender, type of cancer, duration of the central device, or site of device placement. Twenty‐six patients (16%) developed central venous device‐related thrombosis (DRT) during immunotherapy. Low dose warfarin did not appear to prevent thrombosis. Device‐related thrombosis was associated with DRBSI but not with patient gender, type of cancer, type of device, duration or location of device, or concomitant immunotherapy.
CONCLUSIONS
Central venous DRBSI and DRT are significant complications that can occur during moderate dose continuous‐infusion IL‐2 therapy. The risk of DRBSI appears lower than the risk reported with high dose IL‐2 therapy by previous investigators. The risk of DRT appears to be higher than the risk reported for patients with similar devices but not given IL‐2. Low dose warfarin did not prevent DRT when started after device placement. Cancer 2001;91:806–814. © 2001 American Cancer Society.
Central venous device‐related bloodstream infection and device‐related thrombosis (DRT) are significant complications that can occur during moderate dose continuous‐infusion interleukin‐2 therapy. Low dose warfarin did not prevent DRT when started after device pla |
| doi_str_mv | 10.1002/1097-0142(20010215)91:4<806::AID-CNCR1068>3.0.CO;2-K |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_70690627</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>70690627</sourcerecordid><originalsourceid>FETCH-LOGICAL-c4718-763b17f04c1df22a8058ed5e5192380657f50615fc2970a0923a0210e481dc7a3</originalsourceid><addsrcrecordid>eNqVkc1u1DAUhS0EokPhFZAlJASLDNdOHCfTCqkKf1UrRkJFgpXlcW5UQ-IMttOqOzbseUaeBA8zHVYsWFn3-vPx0TmEHDOYMwD-gkEtM2AFf8YBGHAmntdsURxXUC4WJ6evsuZ984FBWb3M5zBvlkc8O7tDZvtnd8kMAKpMFPmnA_IghC9plFzk98kBY7xgXMCM_GjQRa97eoVunAJt8coa_PX9p8deR2ypdR2aaEdHtWtpvPTjsBqDDemCrnW06Xmg0eMf-NrGSzqMLfo00nYMSM3oonVT0k6iSWwKGy3rIvoep6_WpTV_SO51ug_4aHceko9vXl8077Lz5dvT5uQ8M4VkVSbLfMVkB4Vhbce5rkBU2AoUrOZ5ykXITkDJRGd4LUFD2uoUHGBRsdZInR-Sp1vdtR-_TRiiGmww2PfaYXKoJJQ1lFwm8GILGj-G4LFTa28H7W8UA7WpR21yVpuc1W09qmaqUMmGUqkedVuPyhWoZqm4Okuyj3f_T6sB27-iuz4S8GQH6GB033ntjA17rhac8TpRn7fUte3x5r-s_cPZfpf_BpdAuyU</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>70690627</pqid></control><display><type>article</type><title>Central venous device‐related infection and thrombosis in patients treated with moderate dose continuous‐infusion interleukin‐2</title><source>MEDLINE</source><source>Access via Wiley Online Library</source><source>EZB-FREE-00999 freely available EZB journals</source><source>Wiley Online Library (Open Access Collection)</source><source>Alma/SFX Local Collection</source><creator>Eastman, Michael E. ; Khorsand, Masoud ; Maki, Dennis G. ; Williams, Eliot C. ; Kim, KyungMann ; Sondel, Paul M. ; Schiller, Joan H. ; Albertini, Mark R.</creator><creatorcontrib>Eastman, Michael E. ; Khorsand, Masoud ; Maki, Dennis G. ; Williams, Eliot C. ; Kim, KyungMann ; Sondel, Paul M. ; Schiller, Joan H. ; Albertini, Mark R.</creatorcontrib><description>BACKGROUND
This study was performed to determine the incidence of central venous device‐related blood stream infection and thrombosis in patients treated with moderate dose continuous‐infusion interleukin‐2 (IL‐2).
METHODS
The records of 160 consecutive patients treated at the University of Wisconsin Hospital and Clinics, between June 1990 and June 1997, with moderate dose continuous‐infusion IL‐2 (IL‐2 [1.5–3.0 × 106 U/m2/day] Hoffman‐LaRoche, Nutley, NJ or IL‐2 [4.5 × 106 U/m2/day] Chiron Corporation, Berkley, CA) were reviewed retrospectively. The majority of patients had metastatic melanoma (78 patients) or renal cell carcinoma (70 patients). All of the patients had a surgically implanted central venous device placed before starting IL‐2 therapy; 89% of these were cuffed Hickman catheters. Eighty‐four patients received 1 mg of warfarin per day as prophylaxis against device‐related thrombosis; none received periinsertion prophylactic antibiotics.
RESULTS
Twenty‐one patients (13%) developed central venous device‐related bloodstream infection (DRBSI) during the study period, a rate of 2 DRBSI per 1000 device‐days. DRBSIs were associated with the type of immunotherapy given with IL‐2 (P = 0.01) and with thrombosis (odds ratio, 4.1; 95% confidence interval, 1.5–11.4; P = 0.008) but not with patient gender, type of cancer, duration of the central device, or site of device placement. Twenty‐six patients (16%) developed central venous device‐related thrombosis (DRT) during immunotherapy. Low dose warfarin did not appear to prevent thrombosis. Device‐related thrombosis was associated with DRBSI but not with patient gender, type of cancer, type of device, duration or location of device, or concomitant immunotherapy.
CONCLUSIONS
Central venous DRBSI and DRT are significant complications that can occur during moderate dose continuous‐infusion IL‐2 therapy. The risk of DRBSI appears lower than the risk reported with high dose IL‐2 therapy by previous investigators. The risk of DRT appears to be higher than the risk reported for patients with similar devices but not given IL‐2. Low dose warfarin did not prevent DRT when started after device placement. Cancer 2001;91:806–814. © 2001 American Cancer Society.
Central venous device‐related bloodstream infection and device‐related thrombosis (DRT) are significant complications that can occur during moderate dose continuous‐infusion interleukin‐2 therapy. Low dose warfarin did not prevent DRT when started after device placement.</description><identifier>ISSN: 0008-543X</identifier><identifier>EISSN: 1097-0142</identifier><identifier>DOI: 10.1002/1097-0142(20010215)91:4<806::AID-CNCR1068>3.0.CO;2-K</identifier><identifier>PMID: 11241250</identifier><identifier>CODEN: CANCAR</identifier><language>eng</language><publisher>New York: John Wiley & Sons, Inc</publisher><subject>Adult ; Aged ; Antineoplastic agents ; Biological and medical sciences ; Catheterization, Central Venous - adverse effects ; Female ; Humans ; Immunotherapy ; Infusions, Intravenous ; Interleukin-2 - administration & dosage ; Interleukin-2 - therapeutic use ; Male ; Medical sciences ; Middle Aged ; Neoplasms - therapy ; Pharmacology. Drug treatments ; Recombinant Proteins ; Retrospective Studies ; Sepsis - etiology ; Surgical Wound Infection - etiology ; Thrombosis - etiology</subject><ispartof>Cancer, 2001-02, Vol.91 (4), p.806-814</ispartof><rights>Copyright © 2001 American Cancer Society</rights><rights>2001 INIST-CNRS</rights><rights>Copyright 2001 American Cancer Society.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><cites>FETCH-LOGICAL-c4718-763b17f04c1df22a8058ed5e5192380657f50615fc2970a0923a0210e481dc7a3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1002%2F1097-0142%2820010215%2991%3A4%3C806%3A%3AAID-CNCR1068%3E3.0.CO%3B2-K$$EPDF$$P50$$Gwiley$$H</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1002%2F1097-0142%2820010215%2991%3A4%3C806%3A%3AAID-CNCR1068%3E3.0.CO%3B2-K$$EHTML$$P50$$Gwiley$$H</linktohtml><link.rule.ids>315,781,785,1418,1434,27929,27930,45579,45580,46414,46838</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=952129$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/11241250$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Eastman, Michael E.</creatorcontrib><creatorcontrib>Khorsand, Masoud</creatorcontrib><creatorcontrib>Maki, Dennis G.</creatorcontrib><creatorcontrib>Williams, Eliot C.</creatorcontrib><creatorcontrib>Kim, KyungMann</creatorcontrib><creatorcontrib>Sondel, Paul M.</creatorcontrib><creatorcontrib>Schiller, Joan H.</creatorcontrib><creatorcontrib>Albertini, Mark R.</creatorcontrib><title>Central venous device‐related infection and thrombosis in patients treated with moderate dose continuous‐infusion interleukin‐2</title><title>Cancer</title><addtitle>Cancer</addtitle><description>BACKGROUND
This study was performed to determine the incidence of central venous device‐related blood stream infection and thrombosis in patients treated with moderate dose continuous‐infusion interleukin‐2 (IL‐2).
METHODS
The records of 160 consecutive patients treated at the University of Wisconsin Hospital and Clinics, between June 1990 and June 1997, with moderate dose continuous‐infusion IL‐2 (IL‐2 [1.5–3.0 × 106 U/m2/day] Hoffman‐LaRoche, Nutley, NJ or IL‐2 [4.5 × 106 U/m2/day] Chiron Corporation, Berkley, CA) were reviewed retrospectively. The majority of patients had metastatic melanoma (78 patients) or renal cell carcinoma (70 patients). All of the patients had a surgically implanted central venous device placed before starting IL‐2 therapy; 89% of these were cuffed Hickman catheters. Eighty‐four patients received 1 mg of warfarin per day as prophylaxis against device‐related thrombosis; none received periinsertion prophylactic antibiotics.
RESULTS
Twenty‐one patients (13%) developed central venous device‐related bloodstream infection (DRBSI) during the study period, a rate of 2 DRBSI per 1000 device‐days. DRBSIs were associated with the type of immunotherapy given with IL‐2 (P = 0.01) and with thrombosis (odds ratio, 4.1; 95% confidence interval, 1.5–11.4; P = 0.008) but not with patient gender, type of cancer, duration of the central device, or site of device placement. Twenty‐six patients (16%) developed central venous device‐related thrombosis (DRT) during immunotherapy. Low dose warfarin did not appear to prevent thrombosis. Device‐related thrombosis was associated with DRBSI but not with patient gender, type of cancer, type of device, duration or location of device, or concomitant immunotherapy.
CONCLUSIONS
Central venous DRBSI and DRT are significant complications that can occur during moderate dose continuous‐infusion IL‐2 therapy. The risk of DRBSI appears lower than the risk reported with high dose IL‐2 therapy by previous investigators. The risk of DRT appears to be higher than the risk reported for patients with similar devices but not given IL‐2. Low dose warfarin did not prevent DRT when started after device placement. Cancer 2001;91:806–814. © 2001 American Cancer Society.
Central venous device‐related bloodstream infection and device‐related thrombosis (DRT) are significant complications that can occur during moderate dose continuous‐infusion interleukin‐2 therapy. Low dose warfarin did not prevent DRT when started after device placement.</description><subject>Adult</subject><subject>Aged</subject><subject>Antineoplastic agents</subject><subject>Biological and medical sciences</subject><subject>Catheterization, Central Venous - adverse effects</subject><subject>Female</subject><subject>Humans</subject><subject>Immunotherapy</subject><subject>Infusions, Intravenous</subject><subject>Interleukin-2 - administration & dosage</subject><subject>Interleukin-2 - therapeutic use</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Middle Aged</subject><subject>Neoplasms - therapy</subject><subject>Pharmacology. Drug treatments</subject><subject>Recombinant Proteins</subject><subject>Retrospective Studies</subject><subject>Sepsis - etiology</subject><subject>Surgical Wound Infection - etiology</subject><subject>Thrombosis - etiology</subject><issn>0008-543X</issn><issn>1097-0142</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2001</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqVkc1u1DAUhS0EokPhFZAlJASLDNdOHCfTCqkKf1UrRkJFgpXlcW5UQ-IMttOqOzbseUaeBA8zHVYsWFn3-vPx0TmEHDOYMwD-gkEtM2AFf8YBGHAmntdsURxXUC4WJ6evsuZ984FBWb3M5zBvlkc8O7tDZvtnd8kMAKpMFPmnA_IghC9plFzk98kBY7xgXMCM_GjQRa97eoVunAJt8coa_PX9p8deR2ypdR2aaEdHtWtpvPTjsBqDDemCrnW06Xmg0eMf-NrGSzqMLfo00nYMSM3oonVT0k6iSWwKGy3rIvoep6_WpTV_SO51ug_4aHceko9vXl8077Lz5dvT5uQ8M4VkVSbLfMVkB4Vhbce5rkBU2AoUrOZ5ykXITkDJRGd4LUFD2uoUHGBRsdZInR-Sp1vdtR-_TRiiGmww2PfaYXKoJJQ1lFwm8GILGj-G4LFTa28H7W8UA7WpR21yVpuc1W09qmaqUMmGUqkedVuPyhWoZqm4Okuyj3f_T6sB27-iuz4S8GQH6GB033ntjA17rhac8TpRn7fUte3x5r-s_cPZfpf_BpdAuyU</recordid><startdate>20010215</startdate><enddate>20010215</enddate><creator>Eastman, Michael E.</creator><creator>Khorsand, Masoud</creator><creator>Maki, Dennis G.</creator><creator>Williams, Eliot C.</creator><creator>Kim, KyungMann</creator><creator>Sondel, Paul M.</creator><creator>Schiller, Joan H.</creator><creator>Albertini, Mark R.</creator><general>John Wiley & Sons, Inc</general><general>Wiley-Liss</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>20010215</creationdate><title>Central venous device‐related infection and thrombosis in patients treated with moderate dose continuous‐infusion interleukin‐2</title><author>Eastman, Michael E. ; Khorsand, Masoud ; Maki, Dennis G. ; Williams, Eliot C. ; Kim, KyungMann ; Sondel, Paul M. ; Schiller, Joan H. ; Albertini, Mark R.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c4718-763b17f04c1df22a8058ed5e5192380657f50615fc2970a0923a0210e481dc7a3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2001</creationdate><topic>Adult</topic><topic>Aged</topic><topic>Antineoplastic agents</topic><topic>Biological and medical sciences</topic><topic>Catheterization, Central Venous - adverse effects</topic><topic>Female</topic><topic>Humans</topic><topic>Immunotherapy</topic><topic>Infusions, Intravenous</topic><topic>Interleukin-2 - administration & dosage</topic><topic>Interleukin-2 - therapeutic use</topic><topic>Male</topic><topic>Medical sciences</topic><topic>Middle Aged</topic><topic>Neoplasms - therapy</topic><topic>Pharmacology. Drug treatments</topic><topic>Recombinant Proteins</topic><topic>Retrospective Studies</topic><topic>Sepsis - etiology</topic><topic>Surgical Wound Infection - etiology</topic><topic>Thrombosis - etiology</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Eastman, Michael E.</creatorcontrib><creatorcontrib>Khorsand, Masoud</creatorcontrib><creatorcontrib>Maki, Dennis G.</creatorcontrib><creatorcontrib>Williams, Eliot C.</creatorcontrib><creatorcontrib>Kim, KyungMann</creatorcontrib><creatorcontrib>Sondel, Paul M.</creatorcontrib><creatorcontrib>Schiller, Joan H.</creatorcontrib><creatorcontrib>Albertini, Mark R.</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Cancer</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Eastman, Michael E.</au><au>Khorsand, Masoud</au><au>Maki, Dennis G.</au><au>Williams, Eliot C.</au><au>Kim, KyungMann</au><au>Sondel, Paul M.</au><au>Schiller, Joan H.</au><au>Albertini, Mark R.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Central venous device‐related infection and thrombosis in patients treated with moderate dose continuous‐infusion interleukin‐2</atitle><jtitle>Cancer</jtitle><addtitle>Cancer</addtitle><date>2001-02-15</date><risdate>2001</risdate><volume>91</volume><issue>4</issue><spage>806</spage><epage>814</epage><pages>806-814</pages><issn>0008-543X</issn><eissn>1097-0142</eissn><coden>CANCAR</coden><abstract>BACKGROUND
This study was performed to determine the incidence of central venous device‐related blood stream infection and thrombosis in patients treated with moderate dose continuous‐infusion interleukin‐2 (IL‐2).
METHODS
The records of 160 consecutive patients treated at the University of Wisconsin Hospital and Clinics, between June 1990 and June 1997, with moderate dose continuous‐infusion IL‐2 (IL‐2 [1.5–3.0 × 106 U/m2/day] Hoffman‐LaRoche, Nutley, NJ or IL‐2 [4.5 × 106 U/m2/day] Chiron Corporation, Berkley, CA) were reviewed retrospectively. The majority of patients had metastatic melanoma (78 patients) or renal cell carcinoma (70 patients). All of the patients had a surgically implanted central venous device placed before starting IL‐2 therapy; 89% of these were cuffed Hickman catheters. Eighty‐four patients received 1 mg of warfarin per day as prophylaxis against device‐related thrombosis; none received periinsertion prophylactic antibiotics.
RESULTS
Twenty‐one patients (13%) developed central venous device‐related bloodstream infection (DRBSI) during the study period, a rate of 2 DRBSI per 1000 device‐days. DRBSIs were associated with the type of immunotherapy given with IL‐2 (P = 0.01) and with thrombosis (odds ratio, 4.1; 95% confidence interval, 1.5–11.4; P = 0.008) but not with patient gender, type of cancer, duration of the central device, or site of device placement. Twenty‐six patients (16%) developed central venous device‐related thrombosis (DRT) during immunotherapy. Low dose warfarin did not appear to prevent thrombosis. Device‐related thrombosis was associated with DRBSI but not with patient gender, type of cancer, type of device, duration or location of device, or concomitant immunotherapy.
CONCLUSIONS
Central venous DRBSI and DRT are significant complications that can occur during moderate dose continuous‐infusion IL‐2 therapy. The risk of DRBSI appears lower than the risk reported with high dose IL‐2 therapy by previous investigators. The risk of DRT appears to be higher than the risk reported for patients with similar devices but not given IL‐2. Low dose warfarin did not prevent DRT when started after device placement. Cancer 2001;91:806–814. © 2001 American Cancer Society.
Central venous device‐related bloodstream infection and device‐related thrombosis (DRT) are significant complications that can occur during moderate dose continuous‐infusion interleukin‐2 therapy. Low dose warfarin did not prevent DRT when started after device placement.</abstract><cop>New York</cop><pub>John Wiley & Sons, Inc</pub><pmid>11241250</pmid><doi>10.1002/1097-0142(20010215)91:4<806::AID-CNCR1068>3.0.CO;2-K</doi><tpages>9</tpages><oa>free_for_read</oa></addata></record> |
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| source | MEDLINE; Access via Wiley Online Library; EZB-FREE-00999 freely available EZB journals; Wiley Online Library (Open Access Collection); Alma/SFX Local Collection |
| subjects | Adult Aged Antineoplastic agents Biological and medical sciences Catheterization, Central Venous - adverse effects Female Humans Immunotherapy Infusions, Intravenous Interleukin-2 - administration & dosage Interleukin-2 - therapeutic use Male Medical sciences Middle Aged Neoplasms - therapy Pharmacology. Drug treatments Recombinant Proteins Retrospective Studies Sepsis - etiology Surgical Wound Infection - etiology Thrombosis - etiology |
| title | Central venous device‐related infection and thrombosis in patients treated with moderate dose continuous‐infusion interleukin‐2 |
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