{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,18]],"date-time":"2026-09-18T19:23:03Z","timestamp":1789759383863,"version":"4.0.1"},"reference-count":41,"publisher":"MDPI AG","issue":"10","license":[{"start":{"date-parts":[[2021,9,26]],"date-time":"2021-09-26T00:00:00Z","timestamp":1632614400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Medicina"],"abstract":"<jats:p>Background and Objectives: Cancer associated thrombosis (CAT) is a common complication of neoplasms. Multiple myeloma (MM) carries one of the highest risks of CAT, especially in the early phases of treatment. Autologous stem cell transplantation (ASCT) as the standard of care in transplant-eligible patients with MM carries a risk of catheter-related thrombosis (CRT). The aim of this study was identification of the risk factors of CRT in MM patients undergoing ASCT in 2009\u20132019. Materials and Methods: We retrospectively analyzed patients with MM undergoing ASCT. Each patient had central venous catheter (CVC) insertion before the procedure. The clinical symptoms of CRT (edema, redness, pain in the CVC insertion area) were confirmed with Doppler ultrasound examination. We examined the impacts of four groups of factors on CRT development: (1) patient-related: age, gender, Body Mass Index (BMI), obesity, Charlson comorbidity index, hematopoietic stem cell transplantation comorbidity index, renal insufficiency, and previous thrombotic history; (2) disease-related: monoclonal protein type, stage of the disease according to Salmon\u2013Durie and International Staging System, number of prior therapy lines, and MM response before ASCT; (3) treatment-related: melphalan dose, transplant-related complications, and duration of post-ASCT neutropenia; (4) CVC-related: location, time from placement to removal. Results: Symptomatic CRT was present in 2.5% (7\/276) of patients. Univariate analysis showed an increased risk of CRT in patients with a catheter-related infection (OR 2.4, 95% CI; 1.109\u20135.19, p = 0.026), previous thrombotic episode (OR 2.49, 95% CI; 1.15\u20135.39, p = 0.021), previous thrombotic episode on initial myeloma treatment (OR 2.75, 95% CI; 1.15\u20136.53, p = 0.022), and gastrointestinal complications of ASCT such as vomiting and diarrhea (OR 3.87, 95% CI; 1.57\u20139.53, p = 0.003). In multivariate analysis, noninfectious complications were associated with higher CRT incidence (OR 2.75, 95% CI; 1.10\u20136.19, p = 0.031). Conclusions: The incidence of symptomatic CRT in ASCT in MM was relatively low. Previous thrombotic events, especially during the induction of myeloma treatment, increased CRT risk during ASCT. Dehydration following gastrointestinal complications may predispose to higher CRT incidence.<\/jats:p>","DOI":"10.3390\/medicina57101020","type":"journal-article","created":{"date-parts":[[2021,9,27]],"date-time":"2021-09-27T10:39:20Z","timestamp":1632739160000},"page":"1020","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":8,"title":["Risk Factors for Catheter-Related Thrombosis in Multiple Myeloma Patients Undergoing Autologous Stem Cell Transplantation"],"prefix":"10.3390","volume":"57","author":[{"given":"Anna","family":"Hoppe","sequence":"first","affiliation":[{"name":"Department of Hematology and Bone Marrow Transplantation, Poznan University of Medical Sciences, 60-569 Poznan, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1585-6410","authenticated-orcid":false,"given":"Joanna","family":"Rupa-Matysek","sequence":"additional","affiliation":[{"name":"Department of Hematology and Bone Marrow Transplantation, Poznan University of Medical Sciences, 60-569 Poznan, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bartosz","family":"Ma\u0142ecki","sequence":"additional","affiliation":[{"name":"Department of Hematology and Bone Marrow Transplantation, Poznan University of Medical Sciences, 60-569 Poznan, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dominik","family":"Dytfeld","sequence":"additional","affiliation":[{"name":"Department of Hematology and Bone Marrow Transplantation, Poznan University of Medical Sciences, 60-569 Poznan, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5123-9228","authenticated-orcid":false,"given":"Krzysztof","family":"Hoppe","sequence":"additional","affiliation":[{"name":"Department of Nephrology, Transplantology and Internal Diseases, Poznan University of Medical Sciences, 60-355 Poznan, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lidia","family":"Gil","sequence":"additional","affiliation":[{"name":"Department of Hematology and Bone Marrow Transplantation, Poznan University of Medical Sciences, 60-569 Poznan, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2021,9,26]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"715","DOI":"10.1001\/jama.293.6.715","article-title":"Malignancies, prothrombotic mutations, and the risk of venous thrombosis","volume":"293","author":"Blom","year":"2005","journal-title":"JAMA"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"3582","DOI":"10.1182\/blood-2008-04-151076","article-title":"Deep vein thrombosis after monoclonal gammopathy of undetermined significance and multiple myeloma","volume":"112","author":"Kristinsson","year":"2008","journal-title":"Blood"},{"key":"ref_3","doi-asserted-by":"crossref","unstructured":"Fotiou, D., Gavriatopoulou, M., and Terpos, E. (2020). Multiple Myeloma and Thrombosis: Prophylaxis and Risk Prediction Tools. Cancers, 12, Available online: https:\/\/www.ncbi.nlm.nih.gov\/pmc\/articles\/PMC7016665\/.","DOI":"10.3390\/cancers12010191"},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"6063","DOI":"10.1182\/blood-2011-02-297325","article-title":"International Myeloma Working Group consensus approach to the treatment of multiple myeloma patients who are candidates for autologous stem cell transplantation","volume":"117","author":"Cavo","year":"2011","journal-title":"Blood"},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"e20","DOI":"10.1016\/j.bbmt.2018.07.028","article-title":"Catheter-Related Thrombosis in Patients with Lymphoma or Myeloma Undergoing Autologous Stem Cell Transplantation","volume":"24","author":"Hegerova","year":"2018","journal-title":"Biol. Blood Marrow Transpl. J. Am. Soc. Blood Marrow Transplant."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"168","DOI":"10.1177\/112972980100200407","article-title":"Non-tunneled central venous catheters in adult stem cell transplantation recipients: An effective option","volume":"2","author":"Cicconi","year":"2001","journal-title":"J. Vasc. Access"},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"531","DOI":"10.1007\/s00520-012-1554-0","article-title":"Peripherally inserted central catheters (PICCs) in the management of oncohematological patients submitted to autologous stem cell transplantation","volume":"21","author":"Bellesi","year":"2012","journal-title":"Support. Care Cancer"},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"811","DOI":"10.1007\/s00520-008-0561-7","article-title":"Infective and thrombotic complications of central venous catheters in patients with hematological malignancy: Prospective evaluation of nontunneled devices","volume":"17","author":"Worth","year":"2009","journal-title":"Support. Care Cancer"},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"4273","DOI":"10.1182\/blood-2002-09-2731","article-title":"The PARKAA Investigators Central venous line\u2013related thrombosis in children: Association with central venous line location and insertion technique","volume":"101","author":"Male","year":"2003","journal-title":"Blood"},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"363","DOI":"10.1007\/s11239-015-1175-9","article-title":"A systematic review of patient-related risk factors for catheter-related thrombosis","volume":"40","author":"Leung","year":"2015","journal-title":"J. Thromb. Thrombolysis"},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"160","DOI":"10.1177\/1751143715618683","article-title":"Catheter-related thrombosis: A practical approach","volume":"17","author":"Wall","year":"2016","journal-title":"J. Intensiv. Care Soc."},{"key":"ref_12","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":"Hematology"},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"e418","DOI":"10.1200\/EDBK_159009","article-title":"Updated Diagnostic Criteria and Staging System for Multiple Myeloma","volume":"35","author":"Rajkumar","year":"2016","journal-title":"Am. Soc. Clin. Oncol. Educ. Book"},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"1468","DOI":"10.1111\/j.1538-7836.2008.03077.x","article-title":"Incidence of symptomatic venous thromboembolism following hematopoietic stem cell transplantation","volume":"6","author":"Gonsalves","year":"2008","journal-title":"J. Thromb. Haemost."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"433","DOI":"10.1093\/annonc\/mdm350","article-title":"Thrombotic and infectious complications of central venous catheters in patients with hematological malignancies","volume":"19","author":"Boersma","year":"2008","journal-title":"Ann. Oncol."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"e2014011","DOI":"10.4084\/mjhid.2014.011","article-title":"Early and late complications related to central venous catheters in hematological malignancies: A retrospective analysis of 1102 patients","volume":"6","author":"Morano","year":"2014","journal-title":"Mediterr. J. Hematol. Infect. Dis."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"2626","DOI":"10.1097\/00003246-199912000-00004","article-title":"Upper-extremity deep vein thrombosis after central venous catheterization via the axillary vein","volume":"27","author":"Martin","year":"1999","journal-title":"Crit. Care Med."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"847","DOI":"10.1111\/jth.12549","article-title":"Peripherally inserted central catheter-related deep vein thrombosis: Contemporary patterns and predictors","volume":"12","author":"Chopra","year":"2014","journal-title":"J. Thromb. Haemost."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"761","DOI":"10.1016\/j.jvs.2011.10.005","article-title":"Peripherally inserted central catheter usage patterns and associated symptomatic upper extremity venous thrombosis","volume":"55","author":"Liem","year":"2012","journal-title":"J. Vasc. Surg."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"323","DOI":"10.1016\/j.thromres.2012.02.048","article-title":"Incidence and predictive factors of symptomatic thrombosis related to peripherally inserted central catheters in chemotherapy patients","volume":"130","author":"Aw","year":"2012","journal-title":"Thromb Res."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"2655","DOI":"10.1200\/JCO.2005.05.002","article-title":"Infectious complications of central venous catheters increase the risk of catheter-related thrombosis in hematology patients: A prospective study","volume":"23","author":"Schippers","year":"2005","journal-title":"J. Clin. Oncol. Off. J. Am. Soc. Clin. Oncol."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"1303","DOI":"10.1097\/00007890-200211150-00018","article-title":"Hemostatic complications in bone marrow transplantation: A retrospective analysis of 447 patients","volume":"74","author":"Pihusch","year":"2002","journal-title":"Transplantation"},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"473","DOI":"10.1038\/bmt.2015.308","article-title":"Venous thromboembolism in hematopoietic stem cell transplant recipients","volume":"51","author":"Chaturvedi","year":"2016","journal-title":"Bone Marrow Transplant."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"927","DOI":"10.1182\/bloodadvances.2020003442","article-title":"American Society of Hematology 2021 guidelines for management of venous thromboembolism: Prevention and treatment in patients with cancer","volume":"5","author":"Lyman","year":"2021","journal-title":"Blood Adv."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"912","DOI":"10.1055\/s-0037-1615388","article-title":"Home treatment of mild to moderate bleeding episodes using recombinant factor VIIa (Novoseven) in haemophiliacs with inhibitors","volume":"80","author":"Key","year":"1998","journal-title":"Thromb Haemost."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"e566","DOI":"10.1016\/S1470-2045(19)30336-5","article-title":"2019 international clinical practice guidelines for the treatment and prophylaxis of venous thromboembolism in patients with cancer","volume":"20","author":"Farge","year":"2019","journal-title":"Lancet Oncol."},{"key":"ref_27","unstructured":"National Comprehensive Cancer Network (2021, July 17). Cancer-Associated Venous Thromboembolic Disease. Available online: https:\/\/www.nccn.org\/professionals\/physician_gls\/pdf\/vte.pdf."},{"key":"ref_28","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_29","doi-asserted-by":"crossref","first-page":"863","DOI":"10.1177\/0300060514527061","article-title":"Thrombotic risk factors in patients undergoing chemotherapy via peripherally inserted central catheter","volume":"42","author":"Shi","year":"2014","journal-title":"J. Int. Med. Res."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"207","DOI":"10.1378\/chest.114.1.207","article-title":"Central vein catheter-related thrombosis in intensive care patients: Incidence, risks factors, and relationship with catheter-related sepsis","volume":"114","author":"Timsit","year":"1998","journal-title":"Chest"},{"key":"ref_31","first-page":"260","article-title":"Risk factors associated with catheter-related upper extremity deep vein thrombosis in patients with peripherally inserted central venous catheters: A prospective observational cohort study: Part 2","volume":"37","author":"Maneval","year":"2014","journal-title":"J. Infus. Nurs. Off. Publ. Infus. Nurses Soc."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"417","DOI":"10.1002\/jhm.442","article-title":"Risk of venous thromboembolism in hospitalized patients with peripherally inserted central catheters","volume":"4","author":"Lobo","year":"2009","journal-title":"J. Hosp. Med."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"85","DOI":"10.1002\/rth2.12065","article-title":"Acute infection as a trigger for incident venous thromboembolism: Results from a population-based case-crossover study","volume":"2","author":"Grimnes","year":"2018","journal-title":"Res. Pract. Thromb. Haemost."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"1404","DOI":"10.1200\/JCO.2005.03.5600","article-title":"Incidence, Risk Factors, and Outcomes of Catheter-Related Thrombosis in Adult Patients with Cancer","volume":"24","author":"Lee","year":"2006","journal-title":"J. Clin. Oncol."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"837","DOI":"10.1111\/jocn.12227","article-title":"Risk factors associated with PICC-related upper extremity venous thrombosis in cancer patients","volume":"23","author":"Yi","year":"2014","journal-title":"J. Clin. Nurs."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"1073","DOI":"10.1097\/01.smj.0000240707.22171.12","article-title":"Peripherally Inserted Central Venous Catheter-associated Thrombosis: Retrospective Analysis of Clinical Risk Factors in Adult Patients","volume":"99","author":"King","year":"2006","journal-title":"South. Med. J."},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"1014","DOI":"10.1001\/jama.1994.03510370066034","article-title":"The relationship between the thrombotic and infectious complications of central venous catheters","volume":"271","author":"Raad","year":"1994","journal-title":"JAMA"},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"231","DOI":"10.1111\/jth.13911","article-title":"Inflammation and thrombosis: Roles of neutrophils, platelets and endothelial cells and their interactions in thrombus formation during sepsis","volume":"16","author":"Iba","year":"2017","journal-title":"J. Thromb. Haemost."},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"421","DOI":"10.1007\/s15010-007-6350-2","article-title":"Infectious complication in 314 patients after high-dose therapy and autologous hematopoietic stem cell transplantation: Risk factors analysis and outcome","volume":"35","author":"Gil","year":"2007","journal-title":"Infection"},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"245","DOI":"10.1007\/s11239-014-1140-z","article-title":"Differing coagulation profiles of patients with monoclonal gammopathy of undetermined significance and multiple myeloma","volume":"39","author":"Crowley","year":"2015","journal-title":"J. Thromb. Thrombolysis"},{"key":"ref_41","first-page":"1","article-title":"Incidence and risk factors for central venous catheter-related thrombosis in hematological patients","volume":"31","author":"Joks","year":"2013","journal-title":"Med. Oncol."}],"container-title":["Medicina"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/1648-9144\/57\/10\/1020\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T07:05:10Z","timestamp":1760166310000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1648-9144\/57\/10\/1020"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,9,26]]},"references-count":41,"journal-issue":{"issue":"10","published-online":{"date-parts":[[2021,10]]}},"alternative-id":["medicina57101020"],"URL":"https:\/\/doi.org\/10.3390\/medicina57101020","relation":{},"ISSN":["1648-9144"],"issn-type":[{"value":"1648-9144","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,9,26]]}}}