Sakai Toshiro, Shoji Rie, Tanaka Ryoji, Yukitaka Kyoko, Watanabe Ran, Sekiguchi Yuzufumi, Sato Ken, Shimoyama-Ibuki Saori, Goto Akari, Konuma Yuichi
Department of Hematology and Oncology, Asahikawa Red Cross Hospital, 1-1 Akebono-Cho, Asahikawa, Hokkaido, Japan.
Department of Nursing, Asahikawa Red Cross Hospital, Asahikawa, Japan.
Int J Hematol. 2025 Sep 8. doi: 10.1007/s12185-025-04056-3.
Allogeneic hematopoietic stem-cell transplantation (allo-HSCT) requires reliable vascular access for medication, transfusion, and blood sampling, which often involves painful venipuncture. This prospective study evaluated a novel dual peripherally inserted central venous catheter (PICC) technique to reduce venipuncture frequency in allo-HSCT recipients.
The study enrolled 29 allo-HSCT recipients. Each patient received two single-lumen PICCs: Catheter A for tacrolimus infusion and Catheter B, positioned distally, for blood sampling. Tacrolimus concentrations from Catheter B and venipuncture were compared using Bland-Altman analysis. Catheter-related adverse events were also evaluated to assess safety.
PICC placement was successful in all patients. During 1378 catheter-days, one catheter-related bloodstream infection and one catheter occlusion occurred. Tacrolimus concentrations from PICC samples were strongly correlated with those of venipuncture samples (r = 0.93). Bland-Altman analysis showed good agreement, with a mean difference of 0.064 ng/mL, limits of agreement within ± 2.0 ng/mL, and no fixed bias.
Dual single-lumen PICCs provide a safe and accurate method for tacrolimus monitoring in allo-HSCT, and may improve patient experience by reducing the need for painful venipuncture. Further randomized-controlled trials are needed to confirm the benefits of this approach and assess its applicability to the monitoring of other therapeutic agents.
异基因造血干细胞移植（allo-HSCT）需要可靠的血管通路用于给药、输血和采血，这通常涉及痛苦的静脉穿刺。这项前瞻性研究评估了一种新型双腔外周静脉穿刺中心静脉导管（PICC）技术，以减少allo-HSCT受者的静脉穿刺频率。
该研究纳入了29名allo-HSCT受者。每位患者接受两根单腔PICC：导管A用于输注他克莫司，导管B位于远端用于采血。使用Bland-Altman分析比较导管B采集的他克莫司浓度和静脉穿刺采集的浓度。还评估了导管相关不良事件以评估安全性。
所有患者的PICC置管均成功。在1378个导管日期间，发生了1例导管相关血流感染和1例导管堵塞。PICC样本中的他克莫司浓度与静脉穿刺样本中的浓度高度相关（r = 0.93）。Bland-Altman分析显示一致性良好，平均差异为0.064 ng/mL，一致性界限在±2.0 ng/mL以内，且无固定偏差。
双腔单腔PICC为allo-HSCT中他克莫司监测提供了一种安全准确的方法，并且可以通过减少痛苦的静脉穿刺需求来改善患者体验。需要进一步的随机对照试验来证实这种方法的益处并评估其对其他治疗药物监测的适用性。
