{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,25]],"date-time":"2026-09-25T19:16:19Z","timestamp":1790363779147,"version":"4.1.0"},"reference-count":55,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2025,12,15]],"date-time":"2025-12-15T00:00:00Z","timestamp":1765756800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2025,12,15]],"date-time":"2025-12-15T00:00:00Z","timestamp":1765756800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["European J of Haematology"],"published-print":{"date-parts":[[2026,9]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Children diagnosed with leukemia require prolonged central venous access for chemotherapy, transfusions, and supportive care. Due to their immunocompromised status, coagulopathies, and intensive treatment protocols, they may be at increased risk for central venous access device (CVAD)\u2010related complications, including infection, thrombosis, and mechanical failure. This study aimed to quantify the incidence and characterize the nature of CVAD\u2010associated complications in this high\u2010risk pediatric population.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A systematic review (1970\u20132025) was conducted using PRISMA guidelines, including studies describing CVAD\u2010associated complications in children (\u2264\u200918\u2009years old) undergoing treatment for leukemia. The Risk of Bias in Non\u2010Randomized Studies of Interventions (ROBINS\u2010I) tool was used to assess the studies' quality. Meta\u2010analysis and proportional meta\u2010analysis for non\u2010comparative studies (Freeman\u2013Tukey transformation) using the random\u2010effects model were conducted.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Six databases were searched identifying 1126 articles: 1102 were excluded and 24 studies with 13\u2009879 CVADs were included. CVAD\u2010associated complications identified included: device failure 18.5% (95% CI 10.8\u201327.8), central line\u2010associated bloodstream infection (CLABSI) 31.3% (95% CI 23.6\u201339.6), local infection 5.4% (95% CI 2.5\u20139.3), CVAD\u2010associated venous thromboembolism (VTE) 5.2% (95% CI 2.9\u20138.3), dislodgement\/migration 2.4% (95% CI 1.5\u20133.5), breakage\/rupture 3% (95% CI 1.9\u20134.3), occlusion 5.3% (95% CI 1.5\u201311.2), wound dehiscence 4.4% (95% CI 2.2\u20137.3), and accidental removal 4.9% (95% CI 2.0\u20139.0). Tunneled central venous access devices (TCVADs) were associated with a higher proportion of complications when compared to totally implantable venous access devices (TIVADs).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Device failure and CLABSI are the CVAD\u2010associated complications with the highest incidence rates. Comparing CVAD subtypes, TCVADs may have a higher complication risk than TIVADs. Further large prospective studies with long\u2010term follow\u2010up are needed to investigate these findings and determine their impact on patient morbidity and mortality.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/ejh.70080","type":"journal-article","created":{"date-parts":[[2025,12,16]],"date-time":"2025-12-16T00:00:35Z","timestamp":1765843235000},"page":"565-577","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Central Venous Access Device Complications in Children With Leukemia: A Systematic Review and Meta\u2010Analysis"],"prefix":"10.1111","volume":"117","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7254-5232","authenticated-orcid":false,"given":"Mahesh","family":"Sakthivel","sequence":"first","affiliation":[{"name":"Department of Paediatrics, Faculty of Medicine, Nursing and Health Sciences Monash University  Melbourne Australia"},{"name":"Alfred Health  Melbourne 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