Abstract Number: PB1129
Meeting: ISTH 2021 Congress
Theme: Venous Thromboembolism » Cancer Associated Thrombosis
Background: Despite the novel targeted therapies in multiple myeloma, high dose melphalan treatment supported by autologous stem cell transplantation (ASCT) remains the standard of care in transplant-eligible patients. In the majority of patients short term non-tunneled central venous catheter (CVC) is inserted during the procedure. CVC implantation carries the risk of catheter-related thrombosis (CRT).
Aims: The aim of the study was to identify risk factors of CRT in myeloma patients during ASCT.
Methods: We retrospectively analyzed 276 patients undergoing autologous stem cell transplantation in 2009-2019 in the Department of Hematology and Bone Marrow Transplantation. Each patient had CVC insertion before the ASCT procedure. Clinical symptoms of CRT were confirmed with a Doppler ultrasound examination. We examined the impact of patient-related, disease-related, catheter-related and treatment-related factors on CRT development
(Table 1).
| Group | Parameters |
| Patient-related | Age Gender BMI HCT-CI Charlson CI Previous thrombotic history Number of thromboembolic events Thrombotic complications on initial therapy of MM |
| Disease-related | M protein type Stage D-S, ISS, R-ISS Bone disease Kidney insufficiency before ASCT |
| Catheter-related | Location Time from placement to removal |
| Treatment-related | Conditioning type (myeloablative/non-myeloablative) Complications:
|
Factors analyzed in the study Abbreviations: BMI – Body mass index, HCT-CI – Hematopoietic Cell Transplantation-specific Comorbidity Index, Charlson CI – Charlson Comorbidity Index, MM – Multiple myeloma, M protein – monoclonal protein, D-S – Durie Salmon staging system, ISS – International Staging System, R-ISS – Revised International Staging System, ASCT – Autologous stem cell transplantation, CVC – Central Venous Catheter, CVS – Cardiovascular system, GI – Gastrointestinal
Results: Clinically 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 1.11-6.53, p=0.022), previous thrombotic episode during initial MM treatment (OR 2.75; 95%CI 1.15-5.39, p=0.021), any previous thrombotic episode before ASCT (OR 2.49; 95%CI 1.15-5.39, p=0.021) and non-thrombotic/non-infectious complications (OR 2.60; 95%CI 1.10-6.15, p=0.029), especially in patients with gastrointestinal complications such as vomiting and diarrhea (OR 3.87; 95%CI 1.57-9.53, p=0.003). In multivariate analysis, catheter-related infection (OR 2.78; 95%CI 1.21-6.39, p=0.016), previous thrombotic episode before ASCT (OR 2.88; 95%CI 1.24-6.70, p=0.014) and non-thrombotic/non-infectious complications (OR 2.75; 95%CI 1.09-6.91, p=0.031) were all associated with higher CRT incidence.
Conclusions: The incidence of symptomatic CRT in ASCT in MM is lower than in other CVC implantation studies. Previous thrombotic events, especially during induction of MM treatment increase the CRT risk during ASCT. Dehydration following gastrointestinal complications is associated with higher CRT incidence.
To cite this abstract in AMA style:
Hoppe A, Rupa-Matysek J, Malecki B, Dytfeld D, Gil L. Risk Factors of Catheter-related Thrombosis in Patients with Multiple Myeloma Undergoing Autologous Stem Cell Transplantation [abstract]. Res Pract Thromb Haemost. 2021; 5 (Suppl 1). https://abstracts.isth.org/abstract/risk-factors-of-catheter-related-thrombosis-in-patients-with-multiple-myeloma-undergoing-autologous-stem-cell-transplantation/. Accessed September 24, 2021.« Back to ISTH 2021 Congress
ISTH Congress Abstracts - https://abstracts.isth.org/abstract/risk-factors-of-catheter-related-thrombosis-in-patients-with-multiple-myeloma-undergoing-autologous-stem-cell-transplantation/