Association between inherited thrombophilic abnormalities and central venous catheter thrombosis in patients with cancer: a meta-analysis.
BACKGROUND
The risk of deep vein thrombosis (DVT) is increased in cancer patients with central venous catheters (CVC). Factor (F)V Leiden and the G20210A prothrombin mutation (PTM) may play a role in causing catheter-related DVT in patients with cancer. However, information on the association between these thrombophilic abnormalities and CVC-related thrombosis are scarce.


OBJECTIVE
To assess the risk of CVC-related thrombosis associated with these two thrombophilic disorders.


METHODS
MEDLINE and EMBASE databases (up to March 2007); reference lists of retrieved articles. Studies comparing the prevalence of prothrombotic abnormalities in cancer patients with CVC-related thrombosis and in a control group of cancer subjects with CVC without thrombosis. Two reviewers independently selected studies and extracted study characteristics, quality and outcomes. Odds ratios (ORs) and 95% confidence intervals (CIs) were calculated for each trial and pooled.


RESULTS
Ten studies involving 1000 patients were included. The pooled OR for CVC-related thrombosis was 4.6 (95% CI: 2.6, 8.1) in patients with FV Leiden. The pooled OR for CVC-related thrombosis was 4.9 (95% CI: 1.7, 14.3) in patients with PTM. The estimated attributable risk of CVC-related thrombosis was 13.1% for FV Leiden and 4.5% for PTM.


CONCLUSIONS
Our meta-analysis suggests that the presence of FV Leiden and PTM is associated with CVC-related thrombosis.
Dentali
F
F
Department of Clinical Medicine, University of Insubria, Varese, Italy. fdentali@libero.it
Gianni
M
M
Agnelli
G
G
Ageno
W
W
D002405:Catheterization, Central Venous / Q000009:adverse effects*; D005165:Factor V / Q000235:genetics; D006801:Humans; D009369:Neoplasms / Q000097:blood / Q000150:complications*; D016017:Odds Ratio; D017354:Point Mutation; D011516:Prothrombin / Q000235:genetics; D019851:Thrombophilia / Q000235:genetics*; D013927:Thrombosis / Q000209:etiology*
C095381:factor V Leiden; D005165:Factor V; D011516:Prothrombin