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Central venous lines in children with lesser risk acute lymphoblastic leukemia: optimal type and timing of placement.

机译:患急性淋巴细胞性白血病风险较低的儿童的中心静脉线:最佳放置类型和时机。

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PURPOSE: In pediatric patients with acute lymphoblastic leukemia (ALL), the optimal time for central venous line (CVL) insertion and the optimal type of CVL (internal v external) is unclear. This study was undertaken to compare complication rates between early versus late line insertion, and between internal versus external lines in children with lesser risk ALL. PATIENTS AND METHODS: We performed a retrospective analysis of patients enrolled onto Pediatric Oncology Group (POG) protocol 9201. Data regarding demographics, CVL types and insertion dates, blood counts, and complications were reviewed through week 25 of therapy. RESULTS: Of 697 patients enrolled onto POG protocol 9201, 362 patients had sufficient data for analysis. When compared to late line placement (> day 15 of induction), early CVL placement (
机译:目的:在患有急性淋巴细胞白血病(ALL)的儿科患者中,中心静脉线(CVL)插入的最佳时间和最佳的CVL类型(内部v外部)尚不清楚。这项研究的目的是比较ALL风险较低的儿童在早期和晚期行插入之间以及内部和外部行之间的并发症发生率。患者和方法:我们对入选小儿肿瘤组(POG)方案9201的患者进行了回顾性分析。在治疗的第25周,对有关人口统计学,CVL类型和插入日期,血球计数和并发症的数据进行了回顾。结果:入选POG方案9201的697例患者中,有362例具有足够的数据进行分析。与晚线放置(>诱导第15天)相比,早期CVL放置(诱导=第15天)与血液培养阳性的风险增加相关(比值比为2.2; 95%CI为1.0至5.0; P = 0.05)。当与内部CVL(“端口”)进行比较时,外部CVL与阳性血培养相关(奇数比为3.1; 95%CI为1.3至7.5; P = 0.01),血栓形成(奇数比为3.9; 95%CI) ,1.5至10.3; P = 0.006)和CVL去除率(优势比为5.6; 95%CI为2.7至11.6; P <.001)。结论:在ALL风险较低的儿科患者中,由于感染和血栓形成并发症的风险较低,应首选内部管线(端口)作为CVL类型。另外,与诱导后期放置的CVL相比,诱导早期放置的CVL具有更高的阳性血液培养风险。

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