The duration of functioning of a subcutaneous implantable port for the treatment of hematological tumors: a single institution-based study.
BACKGROUND
Although subcutaneous implantable ports have been indicated as venous access for chemotherapy, these devices have not been used routinely for hematological tumors.


METHODS
Between May 2006 and April 2009, 39 ports were implanted in 37 patients with hematological tumors and 16 ports were implanted in 14 patients with nonhematological tumors. The patients were treated with standard/first-line and/or salvage/second-line or greater chemotherapy, and were prospectively followed until port removal, death, or the end of the study.


RESULTS
Thirty-five (96%) patients with hematological tumors developed grade 4 hematological toxicity, while 1 (7%) patient with nonhematological tumors showed grade 4 neutropenia. The actual duration of the port in situ ranged from 14 to 719 days (mean, 271.4 days) in the hematology group, and from 50 to 955 days (mean, 419.5 days) in the nonhematology group (P = 0.039). The Kaplan-Meier-estimated median duration of port in situ in the hematology group was 364 days, which was significantly shorter than that in the nonhematology group (P = 0.009). When patient death and port removal for the end of treatment were censored, the rate of port functioning at 1 year was estimated to be 83% in the hematology group. Bloodstream infection (BSI) occurred in 7 patients with hematological tumors and in 1 patient with metastatic colorectal cancer; however, microbiological confirmation that the implantable port was the source of the BSI was inconclusive.


CONCLUSIONS
The duration of port functioning in patients with hematological tumors was comparable to that in patients with nonhematological tumors. The higher rate of BSI in the hematology group was primarily attributable to profound neutropenia.
Ohno
Hitoshi
H
Department of Hematology, Takeda General Hospital, 28-1 Ishida-Moriminami-cho, Fushimi-ku, Kyoto 601-1495, Japan. hitoshi-ono@fm2.seikyou.ne.jp
Mizumoto
Chisaki
C
Otsuki
Yoshihiro
Y
Oguma
Shigeru
S
Yoshida
Yataro
Y
D000328:Adult; D000368:Aged; D000970:Antineoplastic Agents / Q000008:administration & dosage* / Q000009:adverse effects; D055499:Catheter-Related Infections / Q000209:etiology; D002405:Catheterization, Central Venous / Q000009:adverse effects / Q000295:instrumentation*; D002408:Catheters, Indwelling / Q000009:adverse effects; D020878:Device Removal; D004867:Equipment Design; D005260:Female; D019337:Hematologic Neoplasms / Q000188:drug therapy* / Q000401:mortality; D006801:Humans; D015918:Infusion Pumps, Implantable / Q000009:adverse effects; D007262:Infusions, Intravenous; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D009503:Neutropenia / Q000209:etiology; D011446:Prospective Studies; D013350:Subclavian Vein; D013997:Time Factors; D016896:Treatment Outcome
D000970:Antineoplastic Agents