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Peripherally inserted central catheters in allogeneic hematopoietic stem cell transplant recipients

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Abstract

Background

Central venous catheters (CVC) are essential for the management of patients with hematologic malignancies, facilitating chemotherapy infusion, antibiotics, parenteral nutrition, blood products, and blood samples collection. In this population, peripherally inserted central catheters (PICC) seem to be associated with lower complications, compared with conventional percutaneously inserted devices (CICC). Data on the PICC in allogeneic hematopoietic stem cell recipients (allo-HSCT) are limited.

Methods

We have prospectively evaluated the safety and efficacy of 100 polyurethanes or silicone PICC, inserted into 100 adult allo-HSCT recipients, at the Hematology of Sapienza University of Rome (Italy), between October 2012 and August 2017.

Results

The median duration of PICC placement was 117 days. Overall, 68% of patients maintained the device for the entire transplant procedure and PICC were removed after day 100 from allo-HSCT; of these, 44% did not experienced any PICC-related complications. Catheter-related bloodstream infections (CRBSI) occurred in 32% of patients (2.5/1000 PICC days), associated with thrombosis in 8 cases. CRBSI were observed in 42% of patients with polyurethane and 20% with silicone PICC (p = 0.02). Catheter-related thrombosis occurred in 9% of patients, never requiring anticipated PICC removal. Mechanical complications occurred in 15% of cases (1.2/1000 PICC days). On the whole, adverse events were manageable and did not affect transplant outcome. No deaths related to PICC-complications were observed.

Conclusions

PICC are a safe and reliable long-term venous access in allo-HSCT recipients.

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The authors have full control of all primary data and agree to allow the journal to review their data if requested.

References

  1. Bellesi S, Chiusolo P, De Pascale G et al (2013) Peripherally inserted central catheters (PICCs) in the management of onchoematological patients submitted to autologous stem cell transplantation. Support Care Cancer 21:531–535

    Article  Google Scholar 

  2. Yeral M, Boğa C, Oğuzkurt L, Alışkan HE, Özdoğu H, Demiroğlu YZ (2015) Tunnelled central venous catheter-related problems in the early phase of haematopoietic stem cell transplantation and effects on transplant outcome. Turk J Haematol 32:51–57

    Article  Google Scholar 

  3. Garbin LM, Tonani M, Salvador M, de Campos Pereira Silveira RC, Voltarelli JC, dos Santos C, Carvalho EC (2013) Cyclosporine level: difference between blood samples collected through peripheral and central venous access. J Clin Nurs 22:395–404

    Article  Google Scholar 

  4. Hashimoto Y, Fukuta T, Maruyama J, Omura H, Tanaka T (2017) Experience of peripherally inserted central venous catheter in patients with hematologic diseases. Intern Med 56:389–393

    Article  Google Scholar 

  5. Sakai T, Kohda K, Konuma Y, Hiraoka Y, Ichikawa Y, Ono K, Horiguchi H, Tatekoshi A, Takada K, Iyama S, Kato J (2014) A role for peripherally inserted central venous catheters in the prevention of catheter-related blood stream infections in patients with hematological malignancies. Int J Hematol 100:592–598

    Article  Google Scholar 

  6. McGee DC, Gould MK (2003) Preventing complications of central venous catheterization. N Engl J Med 348:1123–1133

    Article  Google Scholar 

  7. Chopra V, Anand S, Krein SL, Chenoweth C, Saint S (2012) Bloodstream infection, venous thrombosis, and peripherally inserted central catheters: reappraising the evidence. Am J Med 125:733–741

    Article  Google Scholar 

  8. Chopra V, Ratz D, Kuhn L, Lopus T, Chenoweth C, Krein S (2014) PICC-associated bloodstream infections: prevalence, patterns, and predictors. Am J Med 127:319–328

    Article  Google Scholar 

  9. Cornillon J, Martignoles JA, Tavenier-Tardy E et al (2017) Prospective evaluation of systematic use of peripherally inserted central catheters (PICC lines) for the home care after allogeneic hematopoietic stem cells transplantation. Support Care Cancer 25:2843–2847

    Article  CAS  Google Scholar 

  10. Benvenuti S, Ceresoli R, Boroni G, Parolini F, Porta F, Alberti D (2018) Use of peripherally inserted central venous catheters (PICCs) in children receiving autologous or allogeneic stem-cell transplantation. J Vasc Access 19:131–136

    Article  Google Scholar 

  11. Nifong TP, McDevitt TJ (2011) The effect of catheter to vein ratio on blood flow rates in a simulated model of peripherally inserted central venous catheters. Chest. 140:48–53

    Article  Google Scholar 

  12. Sharp R, Cummings M, Fielder A, Mikocka-Walus A, Grech C, Esterman A (2015) The catheter to vein ratio and rates of symptomatic venous thromboembolism in patients with a peripherally inserted central catheter (PICC): a prospective cohort study. Int J Nurs Stud 52:677–685

    Article  Google Scholar 

  13. Gorski LA (2017) The 2016 infusion therapy standards of practice. Home Healthc Now 35(1):10–18

    Article  Google Scholar 

  14. Morano SG, Latagliata R, Girmenia C, Massaro F, Berneschi P, Guerriero A, Giampaoletti M, Sammarco A, Annechini G, Fama A, di Rocco A, Chistolini A, Micozzi A, Molica M, Barberi W, Minotti C, Brunetti GA, Breccia M, Cartoni C, Capria S, Rosa G, Alimena G, Foà R (2015) Catheter-associated bloodstream infections and thrombotic risk in hematologic patients with peripherally inserted central catheters (PICC). Support Care Cancer 23:3289–3295

    Article  Google Scholar 

  15. Mermel LA, Allon M, Bouza E, Craven DE, Flynn P, O'Grady NP, Raad II, Rijnders BJ, Sherertz RJ, Warren DK (2009) Clinical practice guidelines for the diagnosis and management of intravascular catheter-related infection: 2009 update by the Infectious Diseases Society of America. Clin Infect Dis 49:1–45

    Article  CAS  Google Scholar 

  16. McAuliffe E, O’Shea S, Khan MI (2016) PO-02-retrospective audit of the peripherally inerted central catheter (PICC) associated thrombosis in patients with haematological malignancies at Cork University Hospital. Thromb Res 140(Suppl 1):S176

    Article  Google Scholar 

  17. Refaei M, Fernandes B, Brandwein J, Goodyear MD, Pokhrel A, Wu C (2016) Incidence of catheter-related thrombosis in acute leukemia patients: a comparative, retrospective study of the safety of peripherally inserted vs centrally inserted central venous catheters. Ann Hematol 95:2057–2064

    Article  Google Scholar 

  18. Tran H, Arellano M, Chamsuddin A, Flowers C, Heffner LT, Langston A, Lechowicz MJ, Tindol A, Waller E, Winton EF, Khoury HJ (2010) Deep venous thromboses in patients with hematological malignancies after peripherally inserted central venous catheters. Leuk Lymphoma 51:1473–1477

    Article  Google Scholar 

  19. Noailly Charny PA, Bleyzac N, Ohannessian R, Aubert E, Bertrand Y, Renard C (2018) Increased risk of thrombosis associated with peripherally inserted central catheters compared with conventional central venous catheters in children with leukemia. J Pediatr 198:46–52

    Article  Google Scholar 

  20. Zhang XH, Feng FE, Han W, Wang FR, Wang JZ, Wang Y, Chen Y, Fu HX, Mo XD, Zhang YY, Yan CH, Chen H, Chen YH, Liu Y, Xu LP, Liu KY, Huang XJ (2016) High-dose corticosteroid associated with catheter-related thrombosis after allogeneic hematopoietic stem cell transplantation. Thromb Res 144:6–11

    Article  CAS  Google Scholar 

  21. Zochios V, Umar I, Simpson N, Jones N (2014) Peripherally inserted central catheter (PICC)-related thrombosis in critically III patients. J Vasc Access 15:329–337

    Article  Google Scholar 

  22. Mitrović Z, Komljenović I, Jaksic O et al (2014) The use of peripherally inserted central catheter (PICC) in patients with hematological malignancies-a single center experience. Lijec Vjesn 136:136–140

    PubMed  Google Scholar 

  23. Leroyer C, Lashéras A, Marie V, le Bras Y, Carteret T, Dupon M, Rogues AM (2013) Prospective follow-up of complications related to peripherally inserted central catheters. Med Mal Infect 43:350–355

    Article  CAS  Google Scholar 

  24. Jones D, Wismayer K, Bozas G, Palmer J, Elliott M, Maraveyas A (2017) The risk of venous thromboembolism associated with peripherally inserted central catheters in ambulant cancer patients. Thromb J 15:25

    Article  Google Scholar 

  25. Chopra V, Kaatz S, Grant P, Swaminathan L, Boldenow T, Conlon A, Bernstein SJ, Flanders SA (2018) Risk of venous thromboembolism following peripherally inserted central catheter exchange: an analysis of 23,000 hospitalized patients. Am J Med 131:651–660

    Article  Google Scholar 

  26. Lobo BL, Vaidean G, Broyles J, Reaves AB, Shorr RI (2009) Risk of venous thromboembolism in hospitalized patients with peripherally inserted central catheters. J Hosp Med 4:417–422

    Article  Google Scholar 

  27. Paquet F, Boucher LM, Valenti D, Lindsay R (2017) Impact of arm selection on the incidence of PICC complications: results of a randomized controlled trial. J Vasc Access 18:408–414

    Article  Google Scholar 

  28. Del Principe MI, Buccisano F, Maurillo L et al (2013) Infections increase the risk of central venous catheter-related thrombosis in adult acute myeloid leukemia. Thromb Res 132:511–514

    Article  Google Scholar 

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Authors and Affiliations

  1. Hematology, Department of Translational and Precision Medicine, Policlinico Umberto I, Sapienza University of Rome, Via Benevento 6, 00161, Roma, RM, Italy

    Elena Mariggiò, Anna Paola Iori, Alessandra Micozzi, Antonio Chistolini, Roberto Latagliata, Paola Berneschi, Massimo Giampaoletti, Ursula La Rocca, Antonella Bruzzese, Walter Barberi, Robin Foà & Salvatore Giacomo Morano

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  1. Elena Mariggiò
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  2. Anna Paola Iori
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  3. Alessandra Micozzi
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  4. Antonio Chistolini
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  5. Roberto Latagliata
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  6. Paola Berneschi
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  7. Massimo Giampaoletti
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  9. Antonella Bruzzese
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  10. Walter Barberi
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  11. Robin Foà
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  12. Salvatore Giacomo Morano
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Corresponding author

Correspondence to Elena Mariggiò.

Ethics declarations

All procedures followed were in accordance with the ethical standards. All patients were informed about the procedure and its potential complications, and they gave a written informed consent for the insertion of the catheter and for the use of the data for scientific purposes.

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The authors declare that they have no competing interests.

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Mariggiò, E., Iori, A.P., Micozzi, A. et al. Peripherally inserted central catheters in allogeneic hematopoietic stem cell transplant recipients. Support Care Cancer 28, 4193–4199 (2020). https://doi.org/10.1007/s00520-019-05269-z

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