The use of peripheral intravenous catheters (PIV) for lymphoma patients receiving anthracycline-based chemotherapy: A multicenter real-world analysis (RWA).

441 Background: Given a potential risk of extravasation with vesicants and irritants, central venous catheters (CVCs), such as port-a-cath or peripherally inserted central catheters, are commonly utilized for the administration of anthracycline-based chemotherapy. However, CVC placement can result in treatment delay, increased risk of deep vein thrombosis and infection, malfunction, and increased financial and travel toxicity due in part to frequent flushing requirements. Furthermore, there are a paucity of data regarding the safety of PIV for lymphoma (Lym)-based therapy. This multicenter RWA examined the use and associated complications of PIVs to administer CHOP or ABVD-based chemotherapy. Methods: We conducted a retrospective RWA across 7 US centers for patients (pts) ages ≥18 years (yrs) with Lym who received anthracycline-based chemotherapy (or variation) through PIV access between 2010-2024. Detailed baseline characteristics and safety data were obtained. Standard definitions of extravasation and other complications were used (Jackson-Rose J. CJON 2017). Results: A total of 522 patients were included (median age 60 years, IQR 42–71; 55% male; 86% ECOG 0–1; 44.6% stage III–IV). Lymphoma subtypes included: 49% diffuse large B-cell/high-grade lymphoma, 28% Hodgkin lymphoma, 9.5% T-cell lymphoma, 8.4% indolent or mantle cell lymphoma, and 4% B-cell lymphoma NOS. Overall, 71% received CHOP-based and 29% ABVD-based therapy. Chemotherapy was completed via peripheral IV (PIV) in 69.6% of patients, totaling 2135.5 treatment cycles and 2642 unique anthracycline infusion days. PIV-associated complications are detailed in the table. One case of possible extravasation was documented: a 73-year-old woman with DLBCL receiving CHOP developed pain, erythema, induration, and blistering at the IV site following anthracycline. She was treated with DMSO, warm compresses, and analgesics, with complete symptom resolution in one week. No vascular or tissue damage was observed. Conclusions: In this RWA of Lym pts receiving CHOP or ABVD-based therapy over a 15-yr period, use of PIV was effective and associated with a low risk of complications. Moreover, extravasation was rare with 1 reported potential case (i.e., 0.2% of pts treated via PIV and 0.04% of all infusion treatments). PIV complications (%) N=2642 treatment-day infusions. Extravasation 1 (0.04) Malfunction 4 (0.2) Infiltration 7 (0.3) Pain/tenderness 38 (1.4) Erythema at IV site 22 (0.8) Induration/hardness/swelling at IV site 11 (0.4) Phlebitis/cellulitis at IV site 7 (0.3) Thrombosis at IV site 1 (0.04)