Abstract

Deep venous thromboses (DVTs) complicating peripherally inserted central catheters (PICCs) placed for antibiotic administration were observed in 1.4% of patients in the largest study to date that included more than 2000 patients (

Clinical Infectious Diseases
,
34
:
1179
–1183
). The incidence of DVTs associated with PICCs in patients with hematological malignancies is unknown. We designed this retrospective analysis to better determine the incidence, characteristics, and outcomes of PICC-related DVTs on a Leukemia Unit at a large academic institution. Between April 2001 and February 2006, a total of 899 PICCs were placed in 568 patients with hematological malignancies. Ultrasound documented deep venous thromboses occurred in 38 patients (6.69%), a median of 26 days (2–172) after PICC placement. Patient’s characteristics were as follows: median age at the time of PICC insertion 45.5 yrs; 61% male; 37% black and 58% white. At the time of PICC placement 22 (58%) patients had newly diagnosed AML (46%), ALL (36%), lymphoma (13%), or CML (5%). Median platelet count at the time of DVT diagnosis was 106 ×10E3/μL. DVT management included removal of the PICC (71%), thrombectomies/thrombolysis/PTCA (13%), and anticoagulation with heparin (76%), or warfarin (24%). Anticoagulation was subsequently intermittently discontinued due to chemotherapy-induced thrombocytopenias. With a median follow up of 601 days, there were no documented pulmonary emboli or hemorrhages; 50% were in remission, 8% had relapsed disease, and 39% were deceased. In summary, patients with hematological malignancies appear to have a higher incidence of PICC-associated DVTs compared to patients without malignant hematological disorders with PICCs inserted for antibiotic administration. Risk factor analysis is in progress.

Disclosure: No relevant conflicts of interest to declare.

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