Risk Factors for Complications Associated with Peripherally Inserted Central Catheters During Induction Chemotherapy for Acute Myeloid Leukemia

Ban, Tetsuaki; Fujiwara, Shin-ichiro; Murahashi, Rui; Nakajima, HIrotomo; Ikeda, Takashi; Matsuoka, Shinji; Toda, Yumiko; Kawaguchi, Shinichiro; Ito, Shoko; Nagayama, Takashi; Umino, Kento; Minakata, Daisuke; Nakano, Hirofumi; Morita, Kaoru; Ashizawa, Masahiro; Yamamoto, Chiyo; Hatano, Kaoru; Sato, Kazuya; Ohmine, Ken

doi:10.2169/internalmedicine.8184-21

Cited by 6 publications

(5 citation statements)

References 20 publications

(17 reference statements)

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“…Despite data from several studies (32)(33)(34)(35)(36)(37)(38) showing a high incidence of CRBSIs in hematologic patients with PICC, in our evaluation, the rate of bloodstream infections was very low in the HL and NHL populations. These infections were detected during the transplant procedure and were associated with marked neutropenia.…”

Section: Discussioncontrasting

confidence: 82%

“…Thrombotic events have been the major obstacle to the use of PICCs in clinical practice, especially in oncology. Cancer-related hypercoagulative status, reduced vessel lumen, difficult venipuncture due to blind access, and stiffness of materials were considered risk factors for the occurrence of CRT (38)(39)(40). The use of color Doppler ultrasound-guided implantation, new biocompatible materials, and proper selection of available vessels with an appropriate caliber have reduced these risks.…”

Section: Discussionmentioning

confidence: 99%

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Peripherally inserted central catheter insertion and management in Hodgkin and non-Hodgkin lymphomas: a 13-year monocentric experience

Derudas¹,

Massidda²,

Simula³

et al. 2023

Front. Hematol.

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BackgroundNon-Hodgkin’s lymphoma (NHL) and Hodgkin’s lymphoma (HL) are two of the most common hematologic diseases that require an infusion of immunochemotherapies in conjunction with radiotherapy, often in an outpatient setting. For relapsed/refractory disease, autologous peripheral hematopoietic stem cell transplantation and sometimes allogeneic transplantation (HSCT) are considered standard treatment options. Recently, chimeric antigen receptor (CAR) T cells and bispecific antibodies have emerged as an important and effective option for the treatment of relapsed/refractory patients. These medical approaches deserve effective, safe, and durable vascular access, especially for the ambulatory population undergoing discontinuous treatment associated with high rates of complications and life-threatening toxicities. Peripherally inserted central catheters (PICCs) are vascular devices with an intermediate-to-long-term lifespan that are inserted ultrasonically into a peripheral brachial vein. Their ease of insertion by trained nurses and low rate of catheter-related infectious and thrombotic complications make them ideal devices for treating oncology and hematology patients.PurposeIn this study, we aim to demonstrate that PICCs are an essential tool for the treatment of HL and NHL patients in terms of efficiency and safetyMethods and resultsFrom March 2007 to June 2020, 316 PICC implantations were performed by our PICC team in 276 HL patients and 363 PICC in 322 NHL patients. The total lifespan of the PICCs was 50,660 days in HL and 43,919 days in NHL patients. Most PICCs were removed at the end of therapy, and the rate of mechanical complications was low. Only one and four episodes of confirmed PICC-related catheter-related bloodstream infections (CRBSIs) (0.3%; 0.02/1,000 days/PICC and 1.2%; 0.07/1,000 days/PICC) were recorded in HL and NHL patients, respectively. There were only 11 (3.6%; 0.25/1,000 days/PICC) and nine (2.6%; 0.17/1,000 days/PICC) episodes of symptomatic PICC-related thrombotic complications in HL and NHL patients, respectively, without removal.ConclusionOur data indicate that the PICC can be considered the device of choice for treating HL and NHL patients because it is easy to insert, safe to use, long-lasting, and has a low complication rate, especially in the outpatient setting.

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Section: Discussioncontrasting

confidence: 82%

Section: Discussionmentioning

confidence: 99%

Peripherally inserted central catheter insertion and management in Hodgkin and non-Hodgkin lymphomas: a 13-year monocentric experience

Derudas¹,

Massidda²,

Simula³

et al. 2023

Front. Hematol.

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“…Men have a higher risk of thrombosis than women, consistent with Cohen's study [23]. PICC-related thrombosis in patients with a BMI < 18.5 was higher than that in patients with a BMI > 24, which was inconsistent with the results of the study by Ban [24], possibly in the other study, the entire population was overweight/obese [25]. And in this study the patients were cachexic, had poor appetite, and required long-term infusion of viscous substances such as nutrient solution, and their thick and slow-owing blood was more likely to develop venous thrombosis.…”

Section: Discussionmentioning

confidence: 64%

The incidence and risk of different indwelling times of peripherally inserted central catheter-related venous thrombosis in cancer patients: a retrospective analysis of 654 patients

Tan

Chen

et al. 2023

Preprint

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Purpose The purpose of this study was to investigate the incidence of peripherally inserted central catheter-related venous thrombosis (PICC-RVT) in cancer patients with different indwelling times after PICC catheterization, and to explore the main factors related to PICC-RVT in cancer patients. Methods A retrospective study of a total of 654 cancer patients who underwent PICC insertion was conducted from January 2020 to December 2021 in a tertiary hospital in Guangdong Province, China. The risk factors for PICC-RVT in cancer patients were analyzed by logistic regression, including the clinical symptoms of the patients and the monitoring of asymptomatic thrombosis in combination with color Doppler ultrasonography. Results The incidence of PICC-RVT in cancer patients reached 24.9% (n = 163), among which the incidence of thrombosis at 1 month, 3 months, and 6 months and more was 30.6% (n = 11), 25.5% (n = 37) and 18.89% (n = 115), respectively. Multivariable analysis identified 6 variables: "age", "sex", "BMI", “with or without chemotherapy ", "different catheter indwelling duration" and "different cancer types". We observed a trend for a higher risk of PICC-RVT in cancer patients who were male (OR = 1.46, P = 0.035), were older than 69 years (OR = 1.76, P = 0.08), had a BMI < 18.5 (OR = 0.47, P = 0.015), and did not undergo chemotherapy (OR = 0.52, P = 0.048), which were determined to be independent influencing factors for PICC-RVT in cancer patients. Conclusion PICCs had a high incidence of thrombosis in the early indwelling period. The results suggest that patients with cancer who are male, elderly, emaciated, and not receiving chemotherapy should be monitored and treated to prevent PICC-RVT.

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“…CRBSI was higher in hematologic malignancies than in solid tumors. 18 , 19 Ghanem et al found the mean duration of antibiotic therapy in CRBSI was 20.2 days with hematologic and solid tumors. 20 The mean duration of antibiotic treatment in CRBSI in this study was 18 days and was longer as studies in the literature.…”

Section: Discussionmentioning

confidence: 99%

“… 20 The mean duration of antibiotic treatment in CRBSI in this study was 18 days and was longer as studies in the literature. 18 , 20 …”

Section: Discussionmentioning

confidence: 99%

Evaluation of Using Empiric Glycopeptides in Accordance With the Idsa Guideline in Hematologic Malignancy Patients With Febrile Neutropenia

Yalçın

Özkalemkaş

Özkocaman

et al. 2022

Mediterr J Hematol Infect Dis

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Background: This study aimed to evaluate the effects of the appropriate use of empiric glycopeptide therapy in hematologic malignancy patients with febrile neutropenia (FN). Materials and Methods: Patients with FN who were hospitalized in our clinic and started empiric glycopeptide therapy were retrospectively analyzed. Empiric glycopeptide treatment initial indications were determined according to 7 specific criteria in the IDSA guidelines. In addition, the duration of glycopeptide use according to initial indications, causative pathogens in culture positivity, frequency of VRE infection, and the mortality rate was identified. Results: 87 patients were included. Of these, 102 episodes of FN were analyzed. Appropriate use of glycopeptides was observed in 98% of patients. The most common initial indication for glycopeptide was skin or soft-tissue infection, with 52% (n = 53). The mean duration of glycopeptide use was 11 (2–22) days. The duration of glycopeptide use was longer in patients with catheter-related infections than in those with severe mucositis and hemodynamic instability (p = 0,041/p = 0,016). The duration of glycopeptide use was shorter in patients with consolidation therapy than those without consolidation therapy. The mortality rate in culture-positive patients was significantly higher than in those who were culture-negative (p = 0.041). When the patients who were culture-positive and culture-negative were compared, there was no significant difference in the duration of glycopeptide use. Conclusion: This study showed that the mortality rate was higher in culture-positive patients. Additionally, the use of glycopeptides should be discontinued early with no evidence of gram-positive infection. KEYWORDS: HEMATOLOGICAL MALIGNANCIES; GRAM+ INFECTION, GLYCOPEPTIDES,

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Risk Factors for Complications Associated with Peripherally Inserted Central Catheters During Induction Chemotherapy for Acute Myeloid Leukemia

Cited by 6 publications

References 20 publications

Peripherally inserted central catheter insertion and management in Hodgkin and non-Hodgkin lymphomas: a 13-year monocentric experience

Peripherally inserted central catheter insertion and management in Hodgkin and non-Hodgkin lymphomas: a 13-year monocentric experience

The incidence and risk of different indwelling times of peripherally inserted central catheter-related venous thrombosis in cancer patients: a retrospective analysis of 654 patients

Evaluation of Using Empiric Glycopeptides in Accordance With the Idsa Guideline in Hematologic Malignancy Patients With Febrile Neutropenia

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