Document Detail


Central venous lines in children with lesser risk acute lymphoblastic leukemia: optimal type and timing of placement.
MedLine Citation:
PMID:  15860859     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
PURPOSE: In pediatric patients with acute lymphoblastic leukemia (ALL), the optimal time for central venous line (CVL) insertion and the optimal type of CVL (internal v external) is unclear. This study was undertaken to compare complication rates between early versus late line insertion, and between internal versus external lines in children with lesser risk ALL. PATIENTS AND METHODS: We performed a retrospective analysis of patients enrolled onto Pediatric Oncology Group (POG) protocol 9201. Data regarding demographics, CVL types and insertion dates, blood counts, and complications were reviewed through week 25 of therapy. RESULTS: Of 697 patients enrolled onto POG protocol 9201, 362 patients had sufficient data for analysis. When compared to late line placement (> day 15 of induction), early CVL placement (</= day 15 of induction) was associated with an increased risk of having a positive blood culture (odds ratio, 2.2; 95% CI, 1.0 to 5.0; P = .05). When compared with internal CVLs ("ports"), external CVLs were associated with a positive blood culture (odds ratio, 3.1; 95% CI, 1.3 to 7.5; P = .01), thrombosis (odds ratio, 3.9; 95% CI, 1.5 to 10.3; P = .006), and CVL removal (odds ratio, 5.6; 95% CI, 2.7 to 11.6; P < .001). CONCLUSION: In pediatric patients with lesser risk ALL, internal lines (ports) should be the preferred CVL type due to a lower risk of infectious and thrombotic complications. In addition, CVLs placed early in induction are associated with a higher risk of positive blood culture than those placed later in induction.
Authors:
Thomas W McLean; Christen J Fisher; Beverly M Snively; Allen R Chauvenet
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Publication Detail:
Type:  Clinical Trial; Clinical Trial, Phase III; Journal Article; Multicenter Study; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Journal of clinical oncology : official journal of the American Society of Clinical Oncology     Volume:  23     ISSN:  0732-183X     ISO Abbreviation:  J. Clin. Oncol.     Publication Date:  2005 May 
Date Detail:
Created Date:  2005-04-29     Completed Date:  2005-06-03     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  8309333     Medline TA:  J Clin Oncol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  3024-9     Citation Subset:  IM    
Affiliation:
Department of Pediatrics, Wake Forest University School of Medicine, Medical Center Blvd, Winston-Salem, NC 27157, USA. tmclean@wfubmc.edu
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MeSH Terms
Descriptor/Qualifier:
Antineoplastic Combined Chemotherapy Protocols / administration & dosage*,  therapeutic use*
Catheterization, Central Venous / adverse effects*,  methods
Child, Preschool
Female
Humans
Infection
Male
Odds Ratio
Precursor Cell Lymphoblastic Leukemia-Lymphoma / drug therapy*
Retrospective Studies
Risk Factors
Thrombosis / etiology
Time Factors

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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