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Pleural effusions in hematologic malignancies and their management with indwelling pleural catheters

Erik Vakil1, Carlos A Jimenez, Saadia A Faiz

  • 1Department of Pulmonary Medicine, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA.

Current Opinion in Pulmonary Medicine
|April 10, 2018
PubMed
Abstract

Insights

Indwelling pleural catheters (IPCs) offer a safe and effective option for managing malignant pleural effusions (MPEs) in patients with hematologic malignancies. Recent evidence shows comparable complication rates to solid tumors, supporting their wider use.

Area of Science:

  • Oncology
  • Pulmonology
  • Internal Medicine

Background:

  • Pleural effusions in hematologic malignancies can be malignant or secondary.
  • The prognostic impact of malignant pleural effusion (MPE) in this group is not fully understood.
  • Indwelling pleural catheters (IPCs) are used for symptomatic MPE palliation, but concerns exist for hematologic malignancy patients.

Purpose of the Study:

  • To review the evaluation and management of pleural effusions in hematologic malignancies.
  • To outline the use of indwelling pleural catheters (IPCs) for managing these effusions.
  • To address the safety and efficacy of IPCs in this specific patient cohort.

Main Methods:

  • Review of recent retrospective studies on IPC use in hematologic malignancies.
  • Analysis of complication rates and pleurodesis efficacy.
  • Comparison of IPC outcomes in hematologic malignancies versus solid tumors.

Main Results:

  • Lymphomatous effusions are the most frequent MPE in hematologic malignancies.
  • IPC complication and pleurodesis rates in hematologic malignancies are similar to those in solid organ tumors.
  • IPCs are well-tolerated and effective in managing symptomatic MPEs in this population.

Conclusions:

  • Indwelling pleural catheters (IPCs) can be safely managed in patients with hematologic malignancies.
  • Strict sterile techniques and standardized protocols are essential for IPC placement and care.
  • The safety profile of IPCs supports a shift in managing pleural disease for hematologic malignancy patients.

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