# Treatment of Catheter-Associated Internal Jugular Vein Thrombosis Using Apixaban for Less Than Three Months in Two Patients With Aggressive B-cell Lymphoma Undergoing Rituximab, Cyclophosphamide, Doxorubicin, Vincristine, and Prednisolone Therapy

## TL;DR

Two patients with aggressive B-cell lymphoma successfully treated with apixaban for less than three months to resolve catheter-related vein blood clots.

## Contribution

Demonstrates apixaban's effectiveness for short-term treatment of catheter-associated thrombosis in lymphoma patients without requiring catheter removal.

## Key findings

- Apixaban resolved internal jugular vein thrombosis in one patient after 37 days of treatment without catheter removal.
- In another patient, apixaban resolved thrombosis after 66 days alongside continued chemotherapy without catheter removal.
- No recurrence of thrombosis was observed in both patients for several months post-treatment.

## Abstract

The selection of anticoagulant therapy and appropriate duration of treatment for central venous (CV) catheter-associated internal jugular vein thrombosis in patients with malignant lymphoma remain unclear. Two cases of aggressive B-cell lymphomas treated with R-CHOP (rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisolone), in which apixaban administered for less than three months was effective against CV catheter-associated internal jugular vein thrombosis, are reported. In one case, the right internal jugular vein thrombosis developed after eight courses of R-CHOP; when apixaban was orally administered for 37 days after the CV catheter was removed, the thrombus completely dissolved and did not recur for 27 months. In the other case, right internal jugular vein thrombosis developed after four courses of R-CHOP; two additional courses of the R-CHOP were administered alongside oral apixaban administration without catheter removal. After 66 days of oral apixaban, the thrombus completely dissolved, the CV catheter was removed, and no recurrence was observed for 8.5 months.