Annals of Oncology 2008 19(3):433-442; doi:10.1093/annonc/mdm350
Thrombotic and infectious complications of central venous catheters in patients with hematological malignancies
R. S. Boersma1,*, K.-S. G. Jie1, A. Verbon2, E. C. M. van Pampus3 and H. C. Schouten3
1 Atrium Medical Centre Heerlen, Department of Internal Medicine, Heerlen
2 University Hospital Maastricht, Department of Medical Microbiology and Department of Internal Medicine, Division of General Internal Medicine, Section Infectious Diseases
3 University Hospital Maastricht, Department of Internal Medicine, Division of Haematology, Maastricht, The Netherlands
* Correspondence to: Dr R. S. Boersma, University Hospital Maastricht, Department of Internal Medicine, Postbus 5800, 6202 AZ Maastricht, The Netherlands. Tel: +31-43-3877005 ; Fax: +31-43-3875006; E-mail: email@example.com
Central venous catheters (CVCs) have considerably improved the management of patients with hematological malignancies, by facilitating chemotherapy, supportive therapy and blood sampling. Complications of insertion of CVCs include mechanical (arterial puncture, pneumothorax), thrombotic and infectious complications. CVC-related thrombosis and infections are frequently occurring complications and may cause significant morbidity in patients with hematological malignancies. CVC-related thrombosis and infections are related and can therefore not be seen as separate entities. The incidence of symptomatic CVC-related thrombosis had been reported to vary between 1.2 and 13.0% of patients with hematological malignancy. The incidence of CVC-related bloodstream infections varies between 0.0 and 20.8%. There is need for a specific approach regarding diagnosis and treatment of CVC-related thrombosis and infection with specific attention to the preservation of the catheter. Since data on CVC-related infections and thrombosis in hematological patients have been obtained mainly from retrospective studies of small sample size, prospective, randomized studies of prophylactic measures concerning CVC-related thrombosis and infection are warranted.