High risk of deep vein thrombosis associated with peripherally inserted central catheters in lymphoma

Abstract

Peripherally inserted central venous catheters (PICCs) are widely used in cancer patients. Although PICC is a convenient tool, its use is associated with an obvious increase in the incidence of venous thrombosis. The risk factors for deep vein thrombosis associated with the use of PICCs in cancer patients are largely unexplored. This study aimed to investigate the incidence of PICC-associated thrombosis in lymphoma compared with its incidences in other types of cancer. A total of 8028 adult cancer patients inserted with PICC between June 2007 and June 2015 were included in this study. A total of 249 of the 8028 included patients (3.1%) inserted with PICC developed upper extremity deep vein thrombosis (PICC-UEDVT). Patients with lymphoma were more likely to have PICC-UEDVT than those with other types of malignancies (7.1% vs. 2.80%; P < 0.001). Logistic analysis revealed that a lymphoma diagnosis was a risk factor for UEDVT in cancer patients inserted with PICC (OR: 3.849, 95% CI: 2.334–6.347). Patients with lymphoma may be more predisposed to developing PICC-UEDVT than those with other types of malignancies. Identifying the mechanism underlying the relationship between PICC-UEDVT and lymphoma requires further study.

Venous Thromboembolism in Lymphoma: Risk Stratification and Antithrombotic Prophylaxis

“…and V.D.S.). Of the 25 studies included, 12 studies were retrospective single-center studies [7,8,[10][11][12][13][14][15][16][17][18][19], two studies were retrospective multicenter trials [20,21], two pooled analysis of clinical trials [9,22], two meta-analyses [23,24], two analyses of patients [25,26] and three analyses of population-based registries [27][28][29], and two prospective single-center studies [6,30] ( Table 1). Four additional studies were identified by cross-referencing in the 21 published reports.…”

“…and V.D.S.). Of the 25 studies included, 12 studies were retrospective single-center studies [7,8,[10][11][12][13][14][15][16][17][18][19], two studies were retrospective multicenter trials [20,21], two pooled analysis of clinical trials [9,22], two meta-analyses [23,24], two analyses of patients [25,26] and three analyses of population-based registries [27][28][29], and two prospective single-center studies [6,30] (Table 1). Patients included into these studies were identified by institutional databases in 14 studies [7,8,[10][11][12][13][14][15][16][18][19][20][21]30], by the local hospital discharge registry in one study [17], by cancer registries in four studies (California Cancer Registry [27], VA Cancer registry [25], Swedish cancer registry [29], Danish lymphoma database [28]), by clinical trial registries in five ...…”

“…Indwelling central venous catheters (CVC) are associated with increased risk of VTE also in patients with lymphoma. There are only a few studies systematically addressing the VTE risk of CVC [11,28,30]. Some studies report CVC-related VTE without formally analyzing CVC as a risk factor [14,19,28], and one study excluded CVC-related upper extremity DVT [27].…”

“…Some studies report CVC-related VTE without formally analyzing CVC as a risk factor [14,19,28], and one study excluded CVC-related upper extremity DVT [27]. In a single-center study from China, the incidence of upper-extremity deep vein thrombosis related to the presence of a peripherally-inserted CVC (PICC) was 7.1% (40/565) in patients with lymphoma, without significant differences between lymphomas, but significantly higher than in patients with other cancers (209/7463, 2.80%) [11]. In a study from Korea on 686 patients with lymphoma, the incidence of VTE in patients with a CVC (42/460, 9.1%) was higher than in patients without a catheter (12/226, 5.3%, p = 0.042) [30].…”

Risk Factors of PICC-Related Venous Thrombosis in Breast Cancer Patients Undergoing Chemotherapy

“…However, it also induces complications, and catheter-related venous thrombosis is one of its serious complications. 1 , 2 Once thrombosis occurs, transfusion through the PICC catheter is stopped, anticoagulant and thrombolytic therapy are given, and chemotherapy time is delayed. It affects the long-term curative effect of breast cancer treatment and even endangers the patient’s life when it becomes severe.…”