{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,29]],"date-time":"2026-08-29T06:51:25Z","timestamp":1787986285214,"version":"build-2784847793"},"reference-count":32,"publisher":"MDPI AG","issue":"7","license":[{"start":{"date-parts":[[2023,4,4]],"date-time":"2023-04-04T00:00:00Z","timestamp":1680566400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Cancers"],"abstract":"<jats:p>The basilic\/brachial (BBV), internal jugular (IJV), and subclavian veins (SCV) are commonly used as central venous catheter (CVC) sites. A BBV approach [peripherally inserted central catheter (PICC)] is increasingly used for short- to intermediate-term CVCs for acute leukemias undergoing cytotoxic intensive regimens. In this retrospective study, the catheterization of the BBV, IJV, and SCV in patients with previously untreated acute leukemia was assessed. The primary outcome was the composite incidence of catheter-related symptomatic deep-vein thrombosis (sDVT) and bloodstream infection (BSI) from catheterization up to 30 days later. In a 10-year period, 336 CVC were inserted in the BBV (n = 115), IJV (n = 111), and SCV (n = 110) in 336 patients suffering from AML (n = 201) and ALL (n = 135) and undergoing induction chemotherapy. The primary outcome events were 8, 20, and 27 in the BBV, SCV and IJV cohorts (2.6, 6.9, and 9.6 per 1000 catheter-days, respectively; p = 0.002). The primary outcome risk was significantly higher in the IJV-cohort than in the BBV-cohort (HR, 3.6; 95% CI, 1.6 to 7.9; p = 0.001) and in the SCV-cohort than in the BBV-cohort (HR, 2.6; 95% CI, 1.2 to 5.9; p = 0.02). PICC was a valid CVC for the induction chemotherapy of acute leukemia for the lowest risk of sDVT and BSI.<\/jats:p>","DOI":"10.3390\/cancers15072147","type":"journal-article","created":{"date-parts":[[2023,4,5]],"date-time":"2023-04-05T01:39:26Z","timestamp":1680658766000},"page":"2147","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":13,"title":["Intravascular Complications of Central Venous Catheterization by Insertion Site in Acute Leukemia during Remission Induction Chemotherapy Phase: Lower Risk with Peripherally Inserted Catheters in a Single-Center Retrospective Study"],"prefix":"10.3390","volume":"15","author":[{"given":"Marco","family":"Picardi","sequence":"first","affiliation":[{"name":"Hematology Unit, Department of Clinical Medicine and Surgery, Federico II University Medical School, Via Sergio Pansini, 5, 80131 Naples, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Claudia","family":"Giordano","sequence":"additional","affiliation":[{"name":"Hematology Unit, Department of Clinical Medicine and Surgery, Federico II University Medical School, Via Sergio Pansini, 5, 80131 Naples, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Roberta","family":"Della Pepa","sequence":"additional","affiliation":[{"name":"Hematology Unit, Department of Clinical Medicine and Surgery, Federico II University Medical School, Via Sergio Pansini, 5, 80131 Naples, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Novella","family":"Pugliese","sequence":"additional","affiliation":[{"name":"Hematology Unit, Department of Clinical Medicine and Surgery, Federico II University Medical School, Via Sergio Pansini, 5, 80131 Naples, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria","family":"Esposito","sequence":"additional","affiliation":[{"name":"Hematology Unit, Department of Clinical Medicine and Surgery, Federico II University Medical School, Via Sergio Pansini, 5, 80131 Naples, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Davide Pio","family":"Abagnale","sequence":"additional","affiliation":[{"name":"Hematology Unit, Department of Clinical Medicine and Surgery, Federico II University Medical School, Via Sergio Pansini, 5, 80131 Naples, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria Luisa","family":"Giannattasio","sequence":"additional","affiliation":[{"name":"Hematology Unit, Department of Clinical Medicine and Surgery, Federico II University Medical School, Via Sergio Pansini, 5, 80131 Naples, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dario","family":"Lisi","sequence":"additional","affiliation":[{"name":"Hematology Unit, Department of Clinical Medicine and Surgery, Federico II University Medical School, Via Sergio Pansini, 5, 80131 Naples, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Martina","family":"Lamagna","sequence":"additional","affiliation":[{"name":"Hematology Unit, Department of Clinical Medicine and Surgery, Federico II University Medical School, Via Sergio Pansini, 5, 80131 Naples, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Francesco","family":"Grimaldi","sequence":"additional","affiliation":[{"name":"Hematology Unit, Department of Clinical Medicine and Surgery, Federico II University Medical School, Via Sergio Pansini, 5, 80131 Naples, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giada","family":"Muccioli Casadei","sequence":"additional","affiliation":[{"name":"Hematology Unit, Department of Clinical Medicine and Surgery, Federico II University Medical School, Via Sergio Pansini, 5, 80131 Naples, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mauro","family":"Ciriello","sequence":"additional","affiliation":[{"name":"Hematology Unit, Department of Clinical Medicine and Surgery, Federico II University Medical School, Via Sergio Pansini, 5, 80131 Naples, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marcello","family":"Persico","sequence":"additional","affiliation":[{"name":"Department of General Surgery, Endocrinology, Orthopaedics, and Rehabilitations, Federico II University Medical School, Via Sergio Pansini, 5, 80131 Naples, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gianpaolo","family":"Gargiulo","sequence":"additional","affiliation":[{"name":"Hematology Unit, Department of Clinical Medicine and Surgery, Federico II University Medical School, Via Sergio Pansini, 5, 80131 Naples, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2563-4125","authenticated-orcid":false,"given":"Fabrizio","family":"Pane","sequence":"additional","affiliation":[{"name":"Hematology Unit, Department of Clinical Medicine and Surgery, Federico II University Medical School, Via Sergio Pansini, 5, 80131 Naples, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2023,4,4]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"239","DOI":"10.1007\/s00277-020-04286-x","article-title":"Central venous catheter\u2013related infections in hematology and oncology: 2020 updated guidelines on diagnosis, management, and prevention by the Infectious Diseases Working Party (AGIHO) of the German Society of Hematology and Medical Oncology (DGHO)","volume":"100","author":"Boll","year":"2021","journal-title":"Ann. Hematol."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"303","DOI":"10.1002\/ajh.26445","article-title":"The insertion site is the main risk factor for central venous catheter-related complications in patients with hematologic malignancies","volume":"97","author":"Heidenreich","year":"2022","journal-title":"Am. J. Hematol."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"2122","DOI":"10.1093\/annonc\/mdr588","article-title":"Early ultrasonographic finding of septic thrombophlebitis is the main indicator of central venous catheter removal to reduce infection-related mortality in neutropenic patients with bloodstream infection","volume":"23","author":"Picardi","year":"2012","journal-title":"Ann. Oncol."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"473","DOI":"10.1111\/aas.14020","article-title":"Central venous catheter-related complications in hematologic patients: An observational study","volume":"66","author":"Rockholt","year":"2022","journal-title":"Acta Anaesthesiol. Scand."},{"key":"ref_5","doi-asserted-by":"crossref","unstructured":"Baier, C., Linke, L., Eder, M., Schwab, F., Chaberny, I.F., Vonberg, R.P., and Ebadi, E. (2020). Incidence, risk factors and healthcare costs of central line-associated nosocomial bloodstream infections in hematologic and oncologic patients. PLoS ONE, 15.","DOI":"10.1371\/journal.pone.0227772"},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"306","DOI":"10.1182\/asheducation-2014.1.306","article-title":"Central venous catheter\u2013related thrombosis","volume":"2014","author":"Geerts","year":"2014","journal-title":"Hematol. Am. Soc. Hematol. Educ. Prog."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"v152","DOI":"10.1093\/annonc\/mdv296","article-title":"Central venous access in oncology: ESMO clinical practice guidelines","volume":"26","author":"Sousa","year":"2015","journal-title":"Ann. Oncol."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"1357","DOI":"10.1200\/JCO.2012.45.5733","article-title":"Central venous catheter care for the patient with cancer: American Society of Clinical Oncology clinical practice guideline","volume":"31","author":"Schiffer","year":"2013","journal-title":"J. Clin. Oncol."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"93","DOI":"10.1111\/j.1600-0609.1996.tb00304.x","article-title":"Central venous catheter insertion: A bedside procedure for haematological patients","volume":"56","author":"Camera","year":"1996","journal-title":"Eur. J. Haematol."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"e184","DOI":"10.1016\/j.clml.2018.12.008","article-title":"A Frontline Approach with Peripherally Inserted Versus Centrally Inserted Central Venous Catheters for Remission Induction Chemotherapy Phase of Acute Myeloid Leukemia: A Randomized Comparison","volume":"19","author":"Picardi","year":"2019","journal-title":"Clin. Lymphoma Myeloma Leuk."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"2391","DOI":"10.1182\/blood-2016-03-643544","article-title":"The 2016 revision to the World Health Organization classification of myeloid neoplasms and acute leukemia","volume":"127","author":"Arber","year":"2016","journal-title":"Blood"},{"key":"ref_12","first-page":"8","article-title":"Practice guidelines for central venous access 2020. An update report by the Americal Society of Anesthesiologists task force on central venous access","volume":"132","author":"Apfelbaum","year":"2020","journal-title":"Anesthesiology"},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"1105","DOI":"10.1007\/s00134-012-2597-x","article-title":"International evidence-based recommendations on ultrasound-guided vascular access","volume":"38","author":"Lamperti","year":"2012","journal-title":"Intensive Care Med"},{"key":"ref_14","unstructured":"Lumb, P., and Karakitsos, D. (2014). Critical Care Ultrasound, Elsevier-Saunders."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"1500","DOI":"10.1002\/cam4.1063","article-title":"Ultrasonography-driven combination antibiotic therapy with tigecycline significantly increases survival among patients with neutropenic enterocolitis following cytarabine-containing chemotherapy for the remission induction of acute myeloid leukemia","volume":"6","author":"Pugliese","year":"2017","journal-title":"Cancer Med."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"527","DOI":"10.1007\/s00277-018-3441-3","article-title":"(1-3)-\u03b2-D-Glucan serum increase and small-airway-invasive radiological findings as early signs of pulmonary aspergillosis in high-risk hematologic patients in the posaconazole era: Preliminary observations","volume":"98","author":"Picardi","year":"2019","journal-title":"Ann. Hematol."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"1691","DOI":"10.1007\/s00520-018-4138-9","article-title":"Diagnostic-driven antifungal approach in neutropenic patients at high risk for chronic disseminated candidiasis: Preliminary observations on the role of 1,3-\u03b2-D-glucan antigenemia and multiphasic contrast-enhanced computed tomography","volume":"26","author":"Cerchione","year":"2018","journal-title":"Support. Care Cancer"},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"507","DOI":"10.1046\/j.1365-2141.2003.04638.x","article-title":"Central venous catheter related thrombosis in haematology patients and prediction of risk by screening with Doppler-ultrasound","volume":"123","author":"Rosendaal","year":"2003","journal-title":"Br. J. Haematol."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"811","DOI":"10.1111\/j.1365-2141.2005.05529.x","article-title":"Incidence of thrombotic complications in patients with haematological malignancies with central venous catheters: A prospective multicentre study","volume":"129","author":"Cortelezzi","year":"2005","journal-title":"Br. J. Haematol."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"426","DOI":"10.1007\/s11239-020-02040-8","article-title":"PICC-related upper deep venous thrombosis in patients with hematological malignancies. Management of anticoagulant therapy according to the platelet count","volume":"49","author":"Scamuffa","year":"2020","journal-title":"J. Thromb. Thrombolysis"},{"key":"ref_21","first-page":"485","article-title":"Cytosine arabinoside (NSC-63878) and daunorubicin (NSC-83142) therapy in acute nonlymphocytic leukemia","volume":"57","author":"Yates","year":"1973","journal-title":"Cancer Chemother. Rep."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"231","DOI":"10.1007\/s00277-003-0624-2","article-title":"FLAG-IDA in the treatment of refractory\/relapsed acute myeloid leukemia: Single-center experience","volume":"82","author":"Pastore","year":"2003","journal-title":"Ann. Hematol."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"1559","DOI":"10.3324\/haematol.2020.247973","article-title":"Philadelphia-like acute lymphoblastic leukemia is associated with minimal residual disease persistence and poor outcome. First report of the minimal residual disease-oriented GIMEMA LAL1913","volume":"106","author":"Chiaretti","year":"2021","journal-title":"Haematologica"},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"119","DOI":"10.1038\/s41408-020-00383-2","article-title":"Updated risk-oriented strategy for acute lymphoblastic leukemia in adult patients 18\u201365 years: NILG ALL 10\/07","volume":"10","author":"Bassan","year":"2020","journal-title":"Blood Cancer J."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"403","DOI":"10.1016\/S0140-6736(21)00766-2","article-title":"Central venous access devices for the delivery of systemic anticancer therapy (CAVA): A randomised controlled trial","volume":"398","author":"Moss","year":"2021","journal-title":"Lancet"},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"901","DOI":"10.1111\/j.1445-5994.2011.02596.x","article-title":"Essential, but at what risk? A prospective study on central venous access in patients with haematological malignancies","volume":"42","author":"Dix","year":"2012","journal-title":"Intern. Med. J."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"244","DOI":"10.1038\/nrmicro2537","article-title":"The skin microbiome","volume":"9","author":"Grice","year":"2011","journal-title":"Nat. Rev. Microbiol."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"1265","DOI":"10.1007\/s00277-010-1005-2","article-title":"Central venous catheter associated bloodstream infection and colonisation of insertion site and catheter tip. What are the rates and risk factors in haematology patients?","volume":"89","author":"Luft","year":"2010","journal-title":"Ann. Hematol."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"21","DOI":"10.1186\/s12959-015-0052-2","article-title":"Retrospective cohort analysis comparing the incidence of deep vein thromboses between peripherally-inserted and long-term skin tunneled venous catheters in hemato-oncology patients","volume":"13","author":"Sriskandarajah","year":"2015","journal-title":"Thromb. J."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"908","DOI":"10.1086\/671737","article-title":"The risk of bloodstream infection associated with peripherally inserted central catheters compared with central venous catheters in adults: A systematic review and meta-analysis","volume":"34","author":"Chopra","year":"2013","journal-title":"Infect. Control Hosp. Epidemiol."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"2057","DOI":"10.1007\/s00277-016-2798-4","article-title":"Incidence of catheter-related thrombosis in acute leukemia patients: A comparative, retrospective study of the safety of peripherally inserted vs. centrally inserted central venous catheters","volume":"95","author":"Refaei","year":"2016","journal-title":"Ann. Hematol."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"311","DOI":"10.1016\/S0140-6736(13)60592-9","article-title":"Risk of venous thromboembolism associated with peripherally inserted central catheters: A systematic review and meta-analysis","volume":"382","author":"Chopra","year":"2013","journal-title":"Lancet"}],"container-title":["Cancers"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2072-6694\/15\/7\/2147\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T19:10:06Z","timestamp":1760123406000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2072-6694\/15\/7\/2147"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,4,4]]},"references-count":32,"journal-issue":{"issue":"7","published-online":{"date-parts":[[2023,4]]}},"alternative-id":["cancers15072147"],"URL":"https:\/\/doi.org\/10.3390\/cancers15072147","relation":{},"ISSN":["2072-6694"],"issn-type":[{"value":"2072-6694","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,4,4]]}}}