PB0979 - Significantly increased CVC replacement in patients with both symptomatic and incidental venous thrombotic events in pediatric cancer patients: A population-based study

Background: Central venous catheters (CVCs) have significantly improved the care in pediatric cancer patients. However, CVCs are associated with an increased risk of venous thrombotic events (VTE). Replacement of a CVC typically mandates immediate replacement, often requiring surgical intervention and contributes to significantly increased morbidity in patients. The impact of symptomatic and incidental VTE on CVC replacement has not been well studied.

Aims: This study assesses CVC replacement for pediatric cancer patients with symptomatic and incidental VTE as compared to those without VTE.

Methods: After research Ethics Board approval, this study included data for all patients diagnosed between 2005-2020 in the Maritime Provinces of Nova Scotia, New Brunswick, and Prince Edward Island. Statistical analysis was conducted to evaluate CVC replacement in symptomatic, incidental, and no-VTE. Descriptive statistics were used as appropriate.

Results: This study included 771 patients with a male to female ratio of 53:47. There were 43 patients with symptomatic VTE, 57 patients with incidental VTE, and 670 patients with no VTE. Patients with VTE have significantly higher CVC replacement compared to those without VTEs (p < 0.001). Patients with symptomatic VTE, incidental VTE and no VTE required a mean of 2.72 ±1.75, 1.75 ±1.07, and 1.3 ±1.10 CVCs respectively. The differences were statistically significant (p < 0.001). Similarly, greater than one CVC was required in 70%, 47% and 31% of the patients with symptomatic VTE, incidental VTE and no VTE respectively. The differences were statistically significant (p < 0.001) (table 1).

Conclusion(s): ​​CVC replacement in pediatric cancer patients is significantly higher in patients with VTE. Both symptomatic and incidental VTE cause significant CVC replacement as compared to those without VTE. This data suggests that incidental VTE are associated with a significant CVC replacement similar to symptomatic VTE. Further data assessing impact of incidental VTE is needed to optimize management of incidental VTE in pediatric cancer patients.