Treatment of catheter-related thrombosis in patients with hematologic malignancies: A Venous thromboEmbolism Network U.S. retrospective cohort study
Optimal treatment of catheter-related thrombosis (CRT) is uncertain in patients with hematologic malignancy. We aimed to evaluate the treatment strategies, outcomes, and predictors of recurrent venous thromboembolism (VTE) associated with catheter-related thrombosis (CRT) in patients with hematologi...
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| Vydáno v: | Thrombosis research Ročník 202; s. 155 - 161 |
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United States
Elsevier Ltd
01.06.2021
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| Abstract | Optimal treatment of catheter-related thrombosis (CRT) is uncertain in patients with hematologic malignancy. We aimed to evaluate the treatment strategies, outcomes, and predictors of recurrent venous thromboembolism (VTE) associated with catheter-related thrombosis (CRT) in patients with hematologic malignancy.
We performed a multicenter retrospective cohort study of eight institutions through the Venous thromboEmbolism Network US. Patients with hematologic malignancies with documented CRT were identified using ICD-9 and ICD-10 diagnostic codes. Semi-competing risks proportional hazard regression models were created.
Of the 663 patients in the cohort, 124 (19%) were treated with anticoagulation alone, 388 (58%) were treated with anticoagulation and catheter removal, 119 (18%) treated with catheter removal only, and 32 (5%) had neither catheter removal nor anticoagulation. 100 (15%) patients experienced a recurrent VTE event. In the 579 patients who had catheter removal, the most common reason for catheter removal was the CRT [392 (68%)]. For subjects who received any anticoagulation (n = 512), total anticoagulation duration was not associated with VTE recurrence [1.000 (0.999–1.002)]. After adjustment patients treated with catheter removal only had an increased risk of VTE recurrence [2.50 (1.24–5.07)] and death [4.96 (2.47–9.97)]. Patients with no treatment had increased risk of death [16.81 (6.22–45.38)] and death after VTE recurrence [27.29 (3.13–238.13)].
In this large, multicenter retrospective cohort, we found significant variability in the treatment of CRT in patients with hematologic malignancy. Treatment without anticoagulation was associated with recurrent VTE.
•Central venous catheters are associated with catheter related thrombosis (CRT).•Completed a retrospective multicenter cohort of CRT and hematologic malignancy•Many catheters were removed due to thrombosis despite anticoagulation.•Recurrent VTE occurred in 15% of patients.•CRT treatment without anticoagulation was associated with increased VTE recurrence. |
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| AbstractList | Optimal treatment of catheter-related thrombosis (CRT) is uncertain in patients with hematologic malignancy. We aimed to evaluate the treatment strategies, outcomes, and predictors of recurrent venous thromboembolism (VTE) associated with catheter-related thrombosis (CRT) in patients with hematologic malignancy.
We performed a multicenter retrospective cohort study of eight institutions through the Venous thromboEmbolism Network US. Patients with hematologic malignancies with documented CRT were identified using ICD-9 and ICD-10 diagnostic codes. Semi-competing risks proportional hazard regression models were created.
Of the 663 patients in the cohort, 124 (19%) were treated with anticoagulation alone, 388 (58%) were treated with anticoagulation and catheter removal, 119 (18%) treated with catheter removal only, and 32 (5%) had neither catheter removal nor anticoagulation. 100 (15%) patients experienced a recurrent VTE event. In the 579 patients who had catheter removal, the most common reason for catheter removal was the CRT [392 (68%)]. For subjects who received any anticoagulation (n = 512), total anticoagulation duration was not associated with VTE recurrence [1.000 (0.999–1.002)]. After adjustment patients treated with catheter removal only had an increased risk of VTE recurrence [2.50 (1.24–5.07)] and death [4.96 (2.47–9.97)]. Patients with no treatment had increased risk of death [16.81 (6.22–45.38)] and death after VTE recurrence [27.29 (3.13–238.13)].
In this large, multicenter retrospective cohort, we found significant variability in the treatment of CRT in patients with hematologic malignancy. Treatment without anticoagulation was associated with recurrent VTE.
•Central venous catheters are associated with catheter related thrombosis (CRT).•Completed a retrospective multicenter cohort of CRT and hematologic malignancy•Many catheters were removed due to thrombosis despite anticoagulation.•Recurrent VTE occurred in 15% of patients.•CRT treatment without anticoagulation was associated with increased VTE recurrence. Optimal treatment of catheter-related thrombosis (CRT) is uncertain in patients with hematologic malignancy. We aimed to evaluate the treatment strategies, outcomes, and predictors of recurrent venous thromboembolism (VTE) associated with catheter-related thrombosis (CRT) in patients with hematologic malignancy. We performed a multicenter retrospective cohort study of eight institutions through the Venous thromboEmbolism Network US. Patients with hematologic malignancies with documented CRT were identified using ICD-9 and ICD-10 diagnostic codes. Semi-competing risks proportional hazard regression models were created. Of the 663 patients in the cohort, 124 (19%) were treated with anticoagulation alone, 388 (58%) were treated with anticoagulation and catheter removal, 119 (18%) treated with catheter removal only, and 32 (5%) had neither catheter removal nor anticoagulation. 100 (15%) patients experienced a recurrent VTE event. In the 579 patients who had catheter removal, the most common reason for catheter removal was the CRT [392 (68%)]. For subjects who received any anticoagulation (n = 512), total anticoagulation duration was not associated with VTE recurrence [1.000 (0.999-1.002)]. After adjustment patients treated with catheter removal only had an increased risk of VTE recurrence [2.50 (1.24-5.07)] and death [4.96 (2.47-9.97)]. Patients with no treatment had increased risk of death [16.81 (6.22-45.38)] and death after VTE recurrence [27.29 (3.13-238.13)]. In this large, multicenter retrospective cohort, we found significant variability in the treatment of CRT in patients with hematologic malignancy. Treatment without anticoagulation was associated with recurrent VTE. Optimal treatment of catheter-related thrombosis (CRT) is uncertain in patients with hematologic malignancy. We aimed to evaluate the treatment strategies, outcomes, and predictors of recurrent venous thromboembolism (VTE) associated with catheter-related thrombosis (CRT) in patients with hematologic malignancy.INTRODUCTIONOptimal treatment of catheter-related thrombosis (CRT) is uncertain in patients with hematologic malignancy. We aimed to evaluate the treatment strategies, outcomes, and predictors of recurrent venous thromboembolism (VTE) associated with catheter-related thrombosis (CRT) in patients with hematologic malignancy.We performed a multicenter retrospective cohort study of eight institutions through the Venous thromboEmbolism Network US. Patients with hematologic malignancies with documented CRT were identified using ICD-9 and ICD-10 diagnostic codes. Semi-competing risks proportional hazard regression models were created.METHODSWe performed a multicenter retrospective cohort study of eight institutions through the Venous thromboEmbolism Network US. Patients with hematologic malignancies with documented CRT were identified using ICD-9 and ICD-10 diagnostic codes. Semi-competing risks proportional hazard regression models were created.Of the 663 patients in the cohort, 124 (19%) were treated with anticoagulation alone, 388 (58%) were treated with anticoagulation and catheter removal, 119 (18%) treated with catheter removal only, and 32 (5%) had neither catheter removal nor anticoagulation. 100 (15%) patients experienced a recurrent VTE event. In the 579 patients who had catheter removal, the most common reason for catheter removal was the CRT [392 (68%)]. For subjects who received any anticoagulation (n = 512), total anticoagulation duration was not associated with VTE recurrence [1.000 (0.999-1.002)]. After adjustment patients treated with catheter removal only had an increased risk of VTE recurrence [2.50 (1.24-5.07)] and death [4.96 (2.47-9.97)]. Patients with no treatment had increased risk of death [16.81 (6.22-45.38)] and death after VTE recurrence [27.29 (3.13-238.13)]. In this large, multicenter retrospective cohort, we found significant variability in the treatment of CRT in patients with hematologic malignancy. Treatment without anticoagulation was associated with recurrent VTE.RESULTS AND CONCLUSIONSOf the 663 patients in the cohort, 124 (19%) were treated with anticoagulation alone, 388 (58%) were treated with anticoagulation and catheter removal, 119 (18%) treated with catheter removal only, and 32 (5%) had neither catheter removal nor anticoagulation. 100 (15%) patients experienced a recurrent VTE event. In the 579 patients who had catheter removal, the most common reason for catheter removal was the CRT [392 (68%)]. For subjects who received any anticoagulation (n = 512), total anticoagulation duration was not associated with VTE recurrence [1.000 (0.999-1.002)]. After adjustment patients treated with catheter removal only had an increased risk of VTE recurrence [2.50 (1.24-5.07)] and death [4.96 (2.47-9.97)]. Patients with no treatment had increased risk of death [16.81 (6.22-45.38)] and death after VTE recurrence [27.29 (3.13-238.13)]. In this large, multicenter retrospective cohort, we found significant variability in the treatment of CRT in patients with hematologic malignancy. Treatment without anticoagulation was associated with recurrent VTE. AbstractIntroductionOptimal treatment of catheter-related thrombosis (CRT) is uncertain in patients with hematologic malignancy. We aimed to evaluate the treatment strategies, outcomes, and predictors of recurrent venous thromboembolism (VTE) associated with catheter-related thrombosis (CRT) in patients with hematologic malignancy. MethodsWe performed a multicenter retrospective cohort study of eight institutions through the Venous thromboEmbolism Network US. Patients with hematologic malignancies with documented CRT were identified using ICD-9 and ICD-10 diagnostic codes. Semi-competing risks proportional hazard regression models were created. Results and ConclusionsOf the 663 patients in the cohort, 124 (19%) were treated with anticoagulation alone, 388 (58%) were treated with anticoagulation and catheter removal, 119 (18%) treated with catheter removal only, and 32 (5%) had neither catheter removal nor anticoagulation. 100 (15%) patients experienced a recurrent VTE event. In the 579 patients who had catheter removal, the most common reason for catheter removal was the CRT [392 (68%)]. For subjects who received any anticoagulation (n=512), total anticoagulation duration was not associated with VTE recurrence [1.000 (0.999-1.002)]. After adjustment patients treated with catheter removal only had an increased risk of VTE recurrence [2.50 (1.24-5.07)] and death [4.96 (2.47-9.97)]. Patients with no treatment had increased risk of death [16.81 (6.22-45.38)] and death after VTE recurrence [27.29 (3.13-238.13)]. In this large, multicenter retrospective cohort, we found significant variability in the treatment of CRT in patients with hematologic malignancy. Treatment without anticoagulation was associated with recurrent VTE. |
| Author | Gali, Radhika George, Gemlyn Gaddh, Manila Oo, Thein H. Wang, Tzu-Fei Onadeko, Oluwatomiloba Feng, Mingen Streiff, Michael B. Jaglal, Michael Simpson, Pippa Billett, Henny H. Baumann Kreuziger, Lisa Houghton, Damon E. |
| Author_xml | – sequence: 1 givenname: Lisa surname: Baumann Kreuziger fullname: Baumann Kreuziger, Lisa email: lisakreuziger@versiti.org organization: Blood Research Institute, Versiti, Medical College of Wisconsin, Milwaukee, WI, USA – sequence: 2 givenname: Manila surname: Gaddh fullname: Gaddh, Manila organization: Department of Hematology and Medical Oncology, Winship Cancer Institute of Emory University, Atlanta, GA, USA – sequence: 3 givenname: Oluwatomiloba surname: Onadeko fullname: Onadeko, Oluwatomiloba organization: Emory University, Atlanta, GA, USA – sequence: 4 givenname: Gemlyn surname: George fullname: George, Gemlyn organization: Medical College of Wisconsin, Department of Medicine/Hematology and Oncology, Milwaukee, WI, USA – sequence: 5 givenname: Tzu-Fei surname: Wang fullname: Wang, Tzu-Fei organization: Division of Hematology, Department of Internal Medicine, The Ohio State University, Columbus, OH, USA – sequence: 6 givenname: Thein H. surname: Oo fullname: Oo, Thein H. organization: University of Texas MD Anderson Cancer Center, Houston, TX, USA – sequence: 7 givenname: Michael surname: Jaglal fullname: Jaglal, Michael organization: Division of Hematology and Oncology, Department of Hematology and Oncology, Morsani College of Medicine, Moffitt Cancer Center, Tampa, FL, USA – sequence: 8 givenname: Damon E. surname: Houghton fullname: Houghton, Damon E. organization: Department of Cardiovascular Diseases, Division of Vascular Medicine & Department of Medicine, Division of Hematology/Oncology, Mayo Clinic, Rochester, MN, USA – sequence: 9 givenname: Michael B. surname: Streiff fullname: Streiff, Michael B. organization: Division of Hematology, Department of Medicine, Johns Hopkins Medical Institutions, Baltimore, MD, USA – sequence: 10 givenname: Radhika surname: Gali fullname: Gali, Radhika organization: Albert Einstein College of Medicine, Bronx, NY, USA – sequence: 11 givenname: Mingen surname: Feng fullname: Feng, Mingen organization: Division of Quantitative Health Sciences, Department of Pediatrics, Medical College of Wisconsin, Milwaukee, WI, USA – sequence: 12 givenname: Pippa surname: Simpson fullname: Simpson, Pippa organization: Division of Quantitative Health Sciences, Department of Pediatrics, Medical College of Wisconsin, Milwaukee, WI, USA – sequence: 13 givenname: Henny H. surname: Billett fullname: Billett, Henny H. organization: Albert Einstein College of Medicine, Bronx, NY, USA |
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| Keywords | Anticoagulants Haematological malignancy Thrombosis (venous) Catheters Cancer thrombosis (venous) anticoagulants cancer haematological malignancy catheters |
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| SubjectTerms | Anticoagulants Cancer Catheters Haematological malignancy Hematology, Oncology, and Palliative Medicine Thrombosis (venous) |
| Title | Treatment of catheter-related thrombosis in patients with hematologic malignancies: A Venous thromboEmbolism Network U.S. retrospective cohort study |
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