Introduction: It is unknown how the type of central venous catheter (CVC) impacts to the risk of bloodstream infections (BSI) in pediatric patients with acute lymphoblastic leukemia (ALL) undergoing induction therapy. Objectives: We assessed the risk of BSI according to type of CVC among children with ALL undergoing induction therapy. Methods: Patients eligible for our analysis were children at one of three pediatric centers in Denmark with newly diagnosed ALL between 2008 and 2014. Patients were followed from initial CVC placement to first BSI, death, or CVC removal, whichever occurred first. The risk of BSI among patients who had a non-tunneled CVC (nt-CVC) placed was compared with the risk among patients who had a tunneled CVC with external lines (TE). We estimated risk differences 28 days from CVC placement using competing risks regression with adjustment for age, sex, neutropenia at CVC insertion, and ALL risk group. Results: Our study population comprised 136 newly diagnosed pediatric ALL patients. We observed 39 BSIs, of which 65 % were Gram-positive infections and 59 % met the criteria for being CVC-associated. Figure 1 illustrates the cumulative incidence of BSI. The 28-day adjusted risk difference of BSI comparing nt-CVC with TE was -1 % (95 % confidence interval: -18 to 16 %). Subgroup analyses suggested that patients older than 9 years and T-ALL might have lower risk of BSI with TE at diagnosis. Conclusions: The risk of BSIs during induction therapy is similar between patients who had a nt-CVC or TE at diagnosis, but potential variation by age and ALL type should be explored in future studies.
Supportive Care in Cancer, 2015, Vol 23, Issue SUPPL. 1
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