Neoplasms Clinical Trial
Official title:
Outpatient Treatment Of Deep Venous Thrombosis (DVT) Using Subcutaneous Dalteparin (Fragmin) In Low Risk Cancer Patients
Study Plan: Adult cancer patients who have a low risk profile and present with DVT will
receive dalteparin 200 IU/kg subcutaneously daily (based on actual body weight with a maximum
dose of 18,000 IU). Eligible patients who have signed the informed consent will be instructed
on injection technique, will give themselves their first subcutaneous injection under
supervision of the physician or the nurse and will be observed for a minimum of 1-2 hours
prior to discharge. Patients may be admitted to an observation unit for up to 24 hours prior
to discharge if medically necessary. Those patients without complications during the
observation period will be given discharge instructions and an outpatient schedule to see one
of the physician investigators daily for their subcutaneous injection of dalteparin, routine
lab work and initiation of oral anticoagulation therapy.
Patients that are proficient in administering their own injection with dalteparin will be
evaluated every other day by the physician investigator. On days of home injection, the study
nurse will call the patient to check on the patient's status and to remind the patient of
his/her daily injection. Patients will undergo a physical examination every other day by the
physician investigator directed towards the clinically affected areas until a therapeutic
response (INR 2-3) on oral warfarin has been achieved or the patient's clinical condition
warrants modification of therapy with or without hospitalization. Patients will remain on
study for a minimum of 5 days with at least 1 day of therapeutic oral anticoagulation.
The quality of life of the patients enrolled will be assessed by using the Modified Medical
Outcome Study Short Form-20. An adapted version of the Rotterdam Symptom Checklist will be
used to specifically assess patients with thrombosis. Patients will complete these two
instruments at study entry, day 3, day 5 and at the end of study if different from day 5.
n/a
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