Central venous catheter use and the risk of infection in children with acute lymphoblastic leukemia: a report from the Children's Cancer Group.
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.
Rackoff
W R
WR
Section of Pediatric Hematology-Oncology, Riley Hospital for Children, Indianapolis, Indiana, USA.
Ge
J
J
Sather
H N
HN
Cooper
H A
HA
Hutchinson
R J
RJ
Lange
B J
BJ
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
D000970:Antineoplastic Agents