In a double-blind study, patients with phlebographically proven deep venous thrombosis (DVT) were treated with subcutanous injections twice a day of either unfractionated heparin (UH; n = 27) or low molecular weight heparin (LH; n = 29) for 7 days, and the dose was adjusted until therapeutic range was reached, according to a chromogenic substrate anti-Xa assay. Forty-eight percent of the LH group did not need dose adjustment as compared to 24% of the UH group. During the course of heparin administration, deviation from initial heparin activity was frequent in both groups, but mean activity did not indicate a cumulative effect in either group. There was 1 incidence of pulmonary embolism (LH) and only 1 minor bleeding episode (UH). Half of the patients in both groups were phlebographically improved. We conclude that subcutaneous heparin treatment with UH or LH appears safe and convenient.

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A 42-year-old male patient became hospitalized with severe back pain and marked bleeding tendency from disseminated intravascular coagulation. The bone marrow aspirate showed numerous nests of cancer cells presumably from a prostatic carcinoma. After only 4 days of treatment with diethylstilbestrol his condition was markedly improved, and a new bone marrow aspirate showed extensive necrosis of the cancer cells.