title: Biomarkers for Prediction of Central Venous Catheter Related-Thrombosis in Patients With Hematological Malignancies.
abstract: OBJECTIVE
  In a prospective setting, we aimed to find associations between biomarkers of the hemostatic system and the occurrence of central venous catheter (CVC)-related thrombosis in patients with hematological malignancies undergoing intensive chemotherapy.
  
  
  METHODS
  The study was conducted between July 2006 and August 2010 at the University Hospital Maastricht, the Netherlands. Consecutive adult patients with hematological malignancies who were going to receive a CVC for intensive chemotherapy were included. The primary end points were (a) symptomatic CVC-related thrombosis and (b) CVC-related infections. Blood samples were taken directly after catheterization, and easy to determine biomarkers (platelet count, leukocyte count, and hemoglobin level) in combination with blood group, factor VIII (FVIII), plasminogen activator inhibitor 1 (PAI-1), activated protein C (APC) resistance, and free protein S antigen were determined.
  
  
  RESULTS
  Blood was collected and analyzed from 168 patients. The incidence of symptomatic CVC-related thrombosis was 9%. In univariate analysis, white blood cell count >10.6 × 109/L, mean FVIII activity, and PAI-1 >12.2 IU/mL were found to be associated with the development of symptomatic CVC-related thrombosis.
  
  
  CONCLUSIONS
  Elevated leukocyte count, high PAI-1, and high FVIII were associated with an increased incidence of symptomatic CVC-related thrombosis. We hope in future that simple, easy to determine laboratory tests that reflect the hemostatic and fibrinolytic activity in combination with clinical parameters may help to identify hematological patients at highest risk of CVC-related thrombosis and help to tailor the management of thromboprophylaxis in hematological patients undergoing CVC placement.
authors.affiliation: Department of Internal Medicine, Amphia Hospital Breda, Breda, the Netherlands rboersma@amphia.nl.
authors.forename: R S
authors.initials: RS
authors.lastname: Boersma
authors.affiliation: Department of Internal Medicine, Subdivision of Hematology, University Hospital Maastricht, Maastricht, the Netherlands.
authors.forename: K
authors.initials: K
authors.lastname: Hamulyak
authors.affiliation: Laboratory for Clinical Thrombosis and Hemostasis, Cardiovascular Research Institute Maastricht, Maastricht University, Maastricht, the Netherlands.
authors.forename: R
authors.initials: R
authors.lastname: van Oerle
authors.affiliation: Amphia Academy, Amphia Hospital Breda, Breda, the Netherlands.
authors.forename: A
authors.initials: A
authors.lastname: Tuinenburg
authors.affiliation: Laboratory for Clinical Thrombosis and Hemostasis, Cardiovascular Research Institute Maastricht, Maastricht University, Maastricht, the Netherlands.
authors.forename: A J
authors.initials: AJ
authors.lastname: Ten Cate-Hoek
authors.affiliation: Department of Internal Medicine, Subdivision of Hematology, University Hospital Maastricht, Maastricht, the Netherlands.
authors.forename: H C
authors.initials: HC
authors.lastname: Schouten
mesh_terms: D015415:Biomarkers / Q000097:blood*; D062905:Central Venous Catheters / Q000009:adverse effects*; D005260:Female; D019337:Hematologic Neoplasms / Q000150:complications*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D013927:Thrombosis / Q000209:etiology*
chemical_list: D015415:Biomarkers
keywords: biomarkers; central venous catheter-related thrombosis; hematological patients