These authors contributed equally.
Increased risk of central venous catheter–associated thrombosis in acute promyelocytic leukemia: a single-institution experience
Article first published online: 7 MAR 2013
© 2013 John Wiley & Sons A/S
European Journal of Haematology
Volume 90, Issue 5, pages 397–403, May 2013
How to Cite
Grisariu, S., Spectre, G., Kalish, Y. and Gatt, M. E. (2013), Increased risk of central venous catheter–associated thrombosis in acute promyelocytic leukemia: a single-institution experience. European Journal of Haematology, 90: 397–403. doi: 10.1111/ejh.12087
- Issue published online: 18 APR 2013
- Article first published online: 7 MAR 2013
- Accepted manuscript online: 16 FEB 2013 01:34PM EST
- Manuscript Accepted: 4 FEB 2013
- central venous catheter;
- acute leukemia;
- acute promyelocytic leukemia
Patients with acute leukemia and in particular, acute promyelocytic leukemia (APL), are felt to be at high risk for developing venous thromboembolism. The presence of central venous catheters (CVCs) increases this risk; however, reports have varied regarding the frequency of this complication. Current guidelines do not recommend the routine use of prophylactic anticoagulation for patients with CVC.
We suspected an increased incidence of CVC thrombosis in patients with APL and therefore conducted a retrospective survey of 473 patients who were treated for acute leukemia at our institution.
The overall rate of symptomatic CVC thrombosis was 6.8%. We found a significantly (P < 0.001) increased rate of symptomatic CVC thrombosis (32%) in patients with APL as compared with patients with acute lymphocytic leukemia and acute myeloid leukemia (6.4% and 4%, respectively). CVC thrombosis was most prevalent following induction treatment and was associated with higher platelet counts in patients with APL. Following this observation, 13 additional newly diagnosed patients with APL were treated with low molecular weight heparin prophylaxis during the recovery phase after chemotherapy. None had a thrombotic event.
Although our treatment group was small, we suggest considering prophylaxis for CVC thrombosis during platelet recovery after induction treatment in patients with APL.