title: Central venous catheter use and the risk of infection in children with acute lymphoblastic leukemia: a report from the Children's Cancer Group.
abstract: OBJECTIVE
  To describe patterns of central venous catheter (CVC) use and determine the risk of infection associated with a catheter in children with acute lymphoblastic leukemia (ALL).
  
  
  METHODS
  Children with ALL (n = 1934), participating in Children's Cancer Group studies for good-prognosis ALL (CCG-1881) and intermediate-risk ALL (CCG-1891) were evaluated in a retrospective case-control study. The presence of a catheter and the occurrence of infectious complications were recorded after each treatment phase.
  
  
  RESULTS
  Young age and enrollment in the intermediate-risk study were associated with higher rates of catheter use. During each of the first four phases of therapy, the adjusted risk of infection was two- to fourfold higher when a catheter was in place. The proportion of patients with infection during the first four phases of therapy was 2.6 times higher with a CVC (14.4% versus 5.7%). Catheter use was associated with significantly increased hospitalization rates during induction, consolidation, and interim maintenance, but not during delayed intensification. A catheter did not significantly increase the risk of fever during neutropenia.
  
  
  CONCLUSIONS
  The presence of a CVC increases the risk of infection during the early phases of low-intensity therapy for ALL.
authors.affiliation: Section of Pediatric Hematology-Oncology, Riley Hospital for Children, Indianapolis, Indiana, USA.
authors.forename: W R
authors.initials: WR
authors.lastname: Rackoff
authors.forename: J
authors.initials: J
authors.lastname: Ge
authors.forename: H N
authors.initials: HN
authors.lastname: Sather
authors.forename: H A
authors.initials: HA
authors.lastname: Cooper
authors.forename: R J
authors.initials: RJ
authors.lastname: Hutchinson
authors.forename: B J
authors.initials: BJ
authors.lastname: Lange
mesh_terms: D000970:Antineoplastic Agents / Q000008:administration & dosage*; D016022:Case-Control Studies; D002405:Catheterization, Central Venous / Q000009:adverse effects*; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D015994:Incidence; D007239:Infections / Q000209:etiology*; D008297:Male; D054198:Precursor Cell Lymphoblastic Leukemia-Lymphoma / Q000188:drug therapy*; D012189:Retrospective Studies; D012306:Risk; D014481:United States
chemical_list: D000970:Antineoplastic Agents