Treatment of catheter-related thrombosis in patients with hematologic malignancies: A Venous thromboEmbolism Network U.S. retrospective cohort study

Thromb Res. 2021 Jun;202:155-161. doi: 10.1016/j.thromres.2021.03.021. Epub 2021 Apr 6.

Abstract

Introduction: 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.

Methods: 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.

Results and conclusions: 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.

Keywords: Anticoagulants; Cancer; Catheters; Haematological malignancy; Thrombosis (venous).

Publication types

  • Multicenter Study

MeSH terms

  • Anticoagulants / therapeutic use
  • Catheters
  • Hematologic Neoplasms* / complications
  • Hematologic Neoplasms* / therapy
  • Humans
  • Neoplasm Recurrence, Local
  • Recurrence
  • Retrospective Studies
  • Risk Factors
  • Thrombosis*
  • Venous Thromboembolism* / drug therapy
  • Venous Thromboembolism* / etiology

Substances

  • Anticoagulants