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成人白血病/淋巴瘤患者计划外早期拔除植入式静脉导管的危险因素:癌症类型还是不同程度的血细胞减少?

Risk Factors for Unplanned Early Implantable Port Catheter Removal in Adult Leukemia/Lymphoma Patients: Cancer Type or Different Degrees of Cytopenia?

作者信息

Lu Ming-Shian, Chen Chih-Chen, Chang Che-Chia, Lin Chien-Chao, Hsieh Ching-Chuan

机构信息

Department of Surgery, Chang Gung Memorial Hospital at Chiayi, Puzi City 61363, Taiwan.

Department of Medicine, College of Medicine, Chang Gung University, Taoyuan 33302, Taiwan.

出版信息

Cancers (Basel). 2025 Apr 29;17(9):1505. doi: 10.3390/cancers17091505.

Abstract

(1) Background: Implantable port catheters are vital for cancer treatment, but complications such as infections and mechanical failures pose challenges. Lymphoma and leukemia patients' unique cellular abnormalities may influence these risks. This study aimed to determine whether the underlying disease or varying degrees of cytopenia increase the risk of unplanned early port removal. (2) Methods: We conducted a single institution retrospective study that included 368 patients with lymphoma or leukemia who received implantable venous access ports between January 2015 and December 2022. Propensity score matching was employed to compare patients with and without early removals. (3) Results: Univariate analysis revealed statistically significant differences between early and non-early port removal for cancer, hemoglobin, and PG-SGA scores. Cox proportional hazard analysis demonstrated that leukemia patients exhibited a 4.5 times higher risk for unplanned early catheter removal than lymphoma patients did (HR 4.589, 95% CI 1.377-15.299, = 0.013), while patients with normal nutrition, based on the PS-SGA, demonstrated a 75% lower risk of unplanned early catheter removal than those with any degree of malnutrition did (HR 0.258, 95% CI 0.116-0575, < 0.001). Unplanned early catheter removal negatively impacted patient survival. (4) Conclusions: The type of cancer, rather than individual cytopenias, is an independent factor influencing clinical outcomes in lymphoma and leukemia patients.

摘要

(1) 背景:植入式端口导管对癌症治疗至关重要,但感染和机械故障等并发症带来了挑战。淋巴瘤和白血病患者独特的细胞异常情况可能会影响这些风险。本研究旨在确定潜在疾病或不同程度的血细胞减少是否会增加计划外早期拔除端口的风险。(2) 方法:我们进行了一项单机构回顾性研究,纳入了2015年1月至2022年12月期间接受植入式静脉通路端口的368例淋巴瘤或白血病患者。采用倾向评分匹配法比较早期拔除和未早期拔除的患者。(3) 结果:单因素分析显示,癌症、血红蛋白和PG-SGA评分在早期和非早期拔除端口之间存在统计学显著差异。Cox比例风险分析表明,白血病患者计划外早期拔除导管的风险比淋巴瘤患者高4.5倍(HR 4.589,95%CI 1.377-15.299,P = 0.013),而根据PS-SGA,营养正常的患者计划外早期拔除导管的风险比任何程度营养不良的患者低75%(HR 0.258,95%CI 0.116-0.575,P < 0.001)。计划外早期拔除导管对患者生存产生负面影响。(4) 结论:癌症类型而非个体血细胞减少是影响淋巴瘤和白血病患者临床结局的独立因素。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/defb/12071137/82d35f437036/cancers-17-01505-g001.jpg

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