The Use of Indwelling Tunneled Pleural Catheters for Recurrent Pleural Effusions in Patients With Hematologic Malignancies

Gilbert, Christopher R.; Lee, Hans J.; Skalski, Joseph H.; Maldonado, Fabien; Wahidi, Momen M.; Choi, Philip J; Bessich, Jamie L.; Sterman, Daniel H.; Argento, A. Christine; Shojaee, Samira; Gorden, Jed A.; Wilshire, Candice L.; Feller‐Kopman, David; Ortíz, Ricardo; Nonyane, Bareng A. S.; Yarmus, Lonny

doi:10.1378/chest.14-3119

Cited by 48 publications

(44 citation statements)

References 18 publications

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“…A recent series of patients with underlying haematological malignancies treated with IPCs reported infection and mortality rates of 7% and 2%, respectively, despite the high background risks of ongoing chemotherapy and cytopaenia 30. A retrospective cohort study from the Mayo clinic also found no significant differences in the rate of IPC-related pleural infection comparing patients with or without ongoing chemotherapy 31.…”

Section: Introductionmentioning

confidence: 99%

Complications of indwelling pleural catheter use and their management

2016

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The growing utilisation of indwelling pleural catheters (IPCs) has put forward a new era in the management of recurrent symptomatic pleural effusions. IPC use is safe compared to talc pleurodesis, though complications can occur. Pleural infection affects <5% of patients, and is usually responsive to antibiotic treatment without requiring catheter removal or surgery. Pleural loculations develop over time, limiting drainage in 10% of patients, which can be improved with intrapleural fibrinolytic therapy. Catheter tract metastasis can occur with most tumours but is more common in mesothelioma. The metastases usually respond to analgaesics and/or external radiotherapy. Long-term intermittent drainage of exudative effusions or chylothorax can potentially lead to loss of nutrients, though no data exist on any clinical impact. Fibrin clots within the catheter lumen can result in blockage. Chest pain following IPC insertion is often mild, and adjustments in analgaesics and drainage practice are usually all that are required. As clinical experience with the use of IPC accumulates, the profile and natural course of complications are increasingly described. We aim to summarise the available literature on IPC-related complications and the evidence to support specific strategies.

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Section: Introductionmentioning

confidence: 99%

Complications of indwelling pleural catheter use and their management

2016

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“…or being primary [mesotheliomas and primary effusion lymphomas (PEL)]. Malignant pleural effusions are common in patients with hematologic malignancies and they are reported to occur - depending on the specific entity - in up to 48% of such patients [1,2,3], while involvement of the peritoneal and pericardial cavities seems to be less common. Up to 10% of malignant pleural effusions with a positive cytologic examination are due to non-Hodgkin lymphoma (NHL).…”

Section: Introductionmentioning

confidence: 99%

“…In most cases, it causes substantial morbidity and requires treatment. In the study of Gilbert et al [1], among 91 patients with hematologic disease requiring placement of an indwelling pleural catheter, 62% had a diagnosis of a lymphoma, followed by leukemia (21%), and multiple myeloma (13%), with 4 patients having either amyloidosis or myelofibrosis.…”

Section: Introductionmentioning

confidence: 99%

Flow Cytometry and Effusions in Lymphoproliferative Processes and Other Hematologic Neoplasias

Bode-Lesniewska

2016

Acta Cytologica

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Cytopathologists are regularly confronted with lymphocyte-rich effusions, and the definite decision of whether the lymphocytosis is of a purely reactive nature or a presentation of an indolent lymphoma may be an extremely difficult one based on microscopy alone. Flow cytometry (FC) offers many advantages in terms of its application in body cavity fluids, and it has proven to be very useful both in the setting of a known disease and for new lymphoma diagnoses. In this paper, the studies published in recent years dealing with the applications of FC in body cavity effusions in the context of hematologic neoplasia are reviewed, stressing the integrative diagnostic approach. The incorporation of microscopical, immunophenotypical, and molecular findings from examinations of the cellular content of effusions and the interpretation of results in relation to the current WHO classification of hematolymphoid malignancies give cytopathologists new perspectives on advanced and clinically highly relevant diagnostics.

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“…Patients can be trained to drain ascitic or pleural fluid on their own, reducing the number of trips to the hospital and allowing patients to have greater freedom. Though reported complication rates are low, there is a risk of catheter malfunction necessitating repeat office visits and procedures and infection, such as exit site cellulitis, peritonitis or empyema [16][17][18].…”

Section: Tunneled Peritoneal and Pleural And Catheter Placement For Smentioning

confidence: 99%

“…Similar to peritoneal tunneled catheter placement, tunneled pleural catheter placement also promotes patient convenience and comfort [16,23,24]. Alternative treatment options exist for the management of recurrent malignant pleural effusions including repeat thoracentesis and pleurodesis.…”

Section: Tunneled Peritoneal and Pleural And Catheter Placement For Smentioning

confidence: 99%

The role of interventional oncology in the palliative care of cancer patients

Hussaini

Kang

et al. 2016

Expert Review of Quality of Life in Cancer Care

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Interventional oncologists have expertise in delivery of state of the art, minimally invasive, imageguided procedures. As such, interventional oncologists are well-suited to provide palliative options for cancer patients, who often have complex comorbidities precluding them from more invasive options. The broad spectrum of procedures developed into clinical practice highlight the integral role of interventional oncology in the palliation of cancer patients. This review will focus on several of the more common procedures performed by interventional oncologists to provide symptomatic relief: 1. Tunneled peritoneal or pleural catheter placement for fluid drainage; Peritoneovenous shunt placement for fluid drainage; 2. Ablation with focus on metastatic bone ablation for pain control; 3. Neurolysis with focus on celiac neurolysis for pain control; 4. Decompressive gastrostomies or cecostomies for gastric and bowel obstruction; 5. Transarterial embolization for uncontrolled hemorrhage. A description of each procedure and its relative efficacy in providing palliation will be summarized. ARTICLE HISTORY

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The Use of Indwelling Tunneled Pleural Catheters for Recurrent Pleural Effusions in Patients With Hematologic Malignancies

Cited by 48 publications

References 18 publications

Complications of indwelling pleural catheter use and their management

Complications of indwelling pleural catheter use and their management

Flow Cytometry and Effusions in Lymphoproliferative Processes and Other Hematologic Neoplasias

The role of interventional oncology in the palliative care of cancer patients

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