Increased risk of central venous catheter–associated thrombosis in acute promyelocytic leukemia: a single‐institution experience

Background Patients with acute leukemia and in particular, acute promyelocytic leukemia ( APL ), are felt to be at high risk for developing venous thromboembolism. The presence of central venous catheters ( CVCs ) increases this risk; however, reports have varied regarding the frequency of this complication. Current guidelines do not recommend the routine use of prophylactic anticoagulation for patients with CVC . Methods We suspected an increased incidence of CVC thrombosis in patients with APL and therefore conducted a retrospective survey of 473 patients who were treated for acute leukemia at our institution. Results The overall rate of symptomatic CVC thrombosis was 6.8%. We found a significantly ( P  < 0.001) increased rate of symptomatic CVC thrombosis (32%) in patients with APL as compared with patients with acute lymphocytic leukemia and acute myeloid leukemia (6.4% and 4%, respectively). CVC thrombosis was most prevalent following induction treatment and was associated with higher platelet counts in patients with APL . Following this observation, 13 additional newly diagnosed patients with APL were treated with low molecular weight heparin prophylaxis during the recovery phase after chemotherapy. None had a thrombotic event. Conclusions Although our treatment group was small, we suggest considering prophylaxis for CVC thrombosis during platelet recovery after induction treatment in patients with APL .