title: Increased risk of central venous catheter-associated thrombosis in acute promyelocytic leukemia: a single-institution experience.
abstract: BACKGROUND
  Patients with acute leukemia and in particular, acute promyelocytic leukemia (APL), are felt to be at high risk for developing venous thromboembolism. The presence of central venous catheters (CVCs) increases this risk; however, reports have varied regarding the frequency of this complication. Current guidelines do not recommend the routine use of prophylactic anticoagulation for patients with CVC.
  
  
  METHODS
  We suspected an increased incidence of CVC thrombosis in patients with APL and therefore conducted a retrospective survey of 473 patients who were treated for acute leukemia at our institution.
  
  
  RESULTS
  The overall rate of symptomatic CVC thrombosis was 6.8%. We found a significantly (P < 0.001) increased rate of symptomatic CVC thrombosis (32%) in patients with APL as compared with patients with acute lymphocytic leukemia and acute myeloid leukemia (6.4% and 4%, respectively). CVC thrombosis was most prevalent following induction treatment and was associated with higher platelet counts in patients with APL. Following this observation, 13 additional newly diagnosed patients with APL were treated with low molecular weight heparin prophylaxis during the recovery phase after chemotherapy. None had a thrombotic event.
  
  
  CONCLUSIONS
  Although our treatment group was small, we suggest considering prophylaxis for CVC thrombosis during platelet recovery after induction treatment in patients with APL.
authors: Department of Hematology, Hebrew University- Hadassah Medical Center, Jerusalem, Israel.
authors: Sigal
authors: S
authors: Grisariu
authors: Galia
authors: G
authors: Spectre
authors: Yosef
authors: Y
authors: Kalish
authors: Moshe E
authors: ME
authors: Gatt
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002405:Catheterization, Central Venous / Q000009:adverse effects*; D005260:Female; D006801:Humans; D015994:Incidence; D015473:Leukemia, Promyelocytic, Acute / Q000150:complications* / Q000175:diagnosis / Q000628:therapy; D008297:Male; D008875:Middle Aged; D010976:Platelet Count; D012189:Retrospective Studies; D012306:Risk; D016019:Survival Analysis; D056824:Upper Extremity Deep Vein Thrombosis / Q000175:diagnosis / Q000453:epidemiology* / Q000209:etiology*; D055815:Young Adult