Port-A-Cath insertions in acute leukemia: does thrombocytopenia affect morbidity?

Area of Science:

• Pediatric Oncology
• Vascular Access Devices
• Hematology

Background:

• Fear of bleeding complications often delays Port-A-Cath insertion in thrombocytopenic patients.
• This study addresses the safety of Port-A-Cath insertion in acute leukemia patients with varying platelet counts.

Purpose of the Study:

• To compare the morbidity of Port-A-Cath insertions in pediatric acute leukemia patients with platelet counts below and above 50 x 10(9)/L.
• To evaluate the incidence of catheter-related bloodstream infections (CRBSIs) and other complications.

Main Methods:

• Retrospective analysis of 80 Port-A-Cath insertions in pediatric acute leukemia patients (2002-2004).
• Subgroup analysis based on preoperative platelet counts (<50 x 10(9)/L vs. >=50 x 10(9)/L).
• Assessment of CRBSIs, bleeding, and other mechanical complications.

Main Results:

• 27.5% of patients had insertions with platelet counts below 50 x 10(9)/L, managed with transfusions.
• CRBSI incidence was similar between low and high platelet groups (18.2% vs. 17.2%).
• Postoperative bleeding was rare and occurred in the higher platelet count group; other complications were low in both subgroups.

Conclusions:

• Preoperative thrombocytopenia does not increase the risk of Port-A-Cath insertion complications in acute leukemic children.
• Port-A-Cath placement is a safe procedure in this patient population, regardless of platelet levels.