Impact of Perioperative Absolute Neutrophil Count on Central Line-Associated Bloodstream Infection in Children With Acute Lymphoblastic and Myeloid Leukemia

BackgroundThere is lack of evidence concerning safety of placement of tunneled central venous catheters (TCVCs) in neutropenic children with acute leukemias. Here, we evaluate the impact of absolute neutrophil count (ANC) at the time of TCVC placement on development of central line-associated bloods...

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Autores principales:	Illya Martynov, Joachim Schoenberger
Formato:	article
Lenguaje:	EN
Publicado:	Frontiers Media S.A. 2021
Materias:	tunneled central venous catheters neutropenia absolute neutrophil count (ANC) CLABSI ALL—acute lymphoblastic leukemia AML—acute myeloid leukemia Neoplasms. Tumors. Oncology. Including cancer and carcinogens RC254-282
Acceso en línea:	https://doaj.org/article/bcd0ac04f4e64fa0b7d523481dd9d29c
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spelling	oai:doaj.org-article:bcd0ac04f4e64fa0b7d523481dd9d29c2021-11-30T12:13:50ZImpact of Perioperative Absolute Neutrophil Count on Central Line-Associated Bloodstream Infection in Children With Acute Lymphoblastic and Myeloid Leukemia2234-943X10.3389/fonc.2021.770698https://doaj.org/article/bcd0ac04f4e64fa0b7d523481dd9d29c2021-11-01T00:00:00Zhttps://www.frontiersin.org/articles/10.3389/fonc.2021.770698/fullhttps://doaj.org/toc/2234-943XBackgroundThere is lack of evidence concerning safety of placement of tunneled central venous catheters (TCVCs) in neutropenic children with acute leukemias. Here, we evaluate the impact of absolute neutrophil count (ANC) at the time of TCVC placement on development of central line-associated bloodstream infections (CLABSI) in children with lymphoblastic (ALL) or myeloid leukemia (AML).Materials and MethodsA retrospective observational study of children undergoing TCVC placement at a tertiary referral hospital between January 2000 and December 2019 was performed. Traditional and competing-risks regression models were used to estimate the effect of perioperative ANC on development of CLABSI.ResultsA total of 350 children (median age 6.4 [IQR: 3.1–10.9] years) underwent 498 consecutive TCVC implantations in neutropenic (n = 172, 34.5%) and non-neutropenic conditions (n = 326, 65.5%). The median length of observation per TCVC was 217.1 (IQR: 116.1–260.5) days with a total of 99,681 catheter days (CD). There were no differences in early (within first 30 days after TCVC placement) and overall CLABSI rates between neutropenic and non-neutropenic patients (HR 1.250, p = 0.502; HR 1.633, p = 0.143). We identified female sex (HR 2.640, p = 0.006) and the use of TCVC for treatment of relapsed leukemia (HR 4.347, p < 0.0001) as risk factors for early CLABSI and the use of double-lumen catheters (HR 2.607, p = 0.003) and use of TCVCs during leukemia relapse (HR 2.004, p = 0.005) for overall study period.ConclusionThe placement of TCVC in children with neutropenia undergoing anticancer therapy for acute leukemia is safe and not associated with an elevated rate of CLABSI.Illya MartynovIllya MartynovJoachim SchoenbergerJoachim SchoenbergerFrontiers Media S.A.articletunneled central venous cathetersneutropeniaabsolute neutrophil count (ANC)CLABSIALL—acute lymphoblastic leukemiaAML—acute myeloid leukemiaNeoplasms. Tumors. Oncology. Including cancer and carcinogensRC254-282ENFrontiers in Oncology, Vol 11 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	tunneled central venous catheters neutropenia absolute neutrophil count (ANC) CLABSI ALL—acute lymphoblastic leukemia AML—acute myeloid leukemia Neoplasms. Tumors. Oncology. Including cancer and carcinogens RC254-282
spellingShingle	tunneled central venous catheters neutropenia absolute neutrophil count (ANC) CLABSI ALL—acute lymphoblastic leukemia AML—acute myeloid leukemia Neoplasms. Tumors. Oncology. Including cancer and carcinogens RC254-282 Illya Martynov Illya Martynov Joachim Schoenberger Joachim Schoenberger Impact of Perioperative Absolute Neutrophil Count on Central Line-Associated Bloodstream Infection in Children With Acute Lymphoblastic and Myeloid Leukemia
description	BackgroundThere is lack of evidence concerning safety of placement of tunneled central venous catheters (TCVCs) in neutropenic children with acute leukemias. Here, we evaluate the impact of absolute neutrophil count (ANC) at the time of TCVC placement on development of central line-associated bloodstream infections (CLABSI) in children with lymphoblastic (ALL) or myeloid leukemia (AML).Materials and MethodsA retrospective observational study of children undergoing TCVC placement at a tertiary referral hospital between January 2000 and December 2019 was performed. Traditional and competing-risks regression models were used to estimate the effect of perioperative ANC on development of CLABSI.ResultsA total of 350 children (median age 6.4 [IQR: 3.1–10.9] years) underwent 498 consecutive TCVC implantations in neutropenic (n = 172, 34.5%) and non-neutropenic conditions (n = 326, 65.5%). The median length of observation per TCVC was 217.1 (IQR: 116.1–260.5) days with a total of 99,681 catheter days (CD). There were no differences in early (within first 30 days after TCVC placement) and overall CLABSI rates between neutropenic and non-neutropenic patients (HR 1.250, p = 0.502; HR 1.633, p = 0.143). We identified female sex (HR 2.640, p = 0.006) and the use of TCVC for treatment of relapsed leukemia (HR 4.347, p < 0.0001) as risk factors for early CLABSI and the use of double-lumen catheters (HR 2.607, p = 0.003) and use of TCVCs during leukemia relapse (HR 2.004, p = 0.005) for overall study period.ConclusionThe placement of TCVC in children with neutropenia undergoing anticancer therapy for acute leukemia is safe and not associated with an elevated rate of CLABSI.
format	article
author	Illya Martynov Illya Martynov Joachim Schoenberger Joachim Schoenberger
author_facet	Illya Martynov Illya Martynov Joachim Schoenberger Joachim Schoenberger
author_sort	Illya Martynov
title	Impact of Perioperative Absolute Neutrophil Count on Central Line-Associated Bloodstream Infection in Children With Acute Lymphoblastic and Myeloid Leukemia
title_short	Impact of Perioperative Absolute Neutrophil Count on Central Line-Associated Bloodstream Infection in Children With Acute Lymphoblastic and Myeloid Leukemia
title_full	Impact of Perioperative Absolute Neutrophil Count on Central Line-Associated Bloodstream Infection in Children With Acute Lymphoblastic and Myeloid Leukemia
title_fullStr	Impact of Perioperative Absolute Neutrophil Count on Central Line-Associated Bloodstream Infection in Children With Acute Lymphoblastic and Myeloid Leukemia
title_full_unstemmed	Impact of Perioperative Absolute Neutrophil Count on Central Line-Associated Bloodstream Infection in Children With Acute Lymphoblastic and Myeloid Leukemia
title_sort	impact of perioperative absolute neutrophil count on central line-associated bloodstream infection in children with acute lymphoblastic and myeloid leukemia
publisher	Frontiers Media S.A.
publishDate	2021
url	https://doaj.org/article/bcd0ac04f4e64fa0b7d523481dd9d29c
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Impact of Perioperative Absolute Neutrophil Count on Central Line-Associated Bloodstream Infection in Children With Acute Lymphoblastic and Myeloid Leukemia

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