Catheter-related complications in AML remission induction chemotherapy: a retrospective comparison of PICCs and CICCs

PURPOSE: Central venous catheters (CVCs) are a cornerstone for effective supportive therapy in patients with AML undergoing remission induction chemotherapy. While peripherally inserted central catheters (PICCs) are increasingly used as an alternative to centrally inserted central catheters (CICCs), real world data on their implications on AML and supportive therapy remain limited. This study aimed to compare infectious and non-infectious complications of PICCs vs. CICCs in this population. METHODS: We conducted a single-center retrospective cohort study of 116 AML patients receiving induction chemotherapy between June 2019 and March 2024. Patients received either a PICC (n = 59) or a CICC (n = 57). Catheter-related complications were analyzed as incidence rates per 1000 catheter days. RESULTS: PICCs had a longer median dwell time than CICCs (16 vs. 11 days, p = 0.004). Catheter-related bloodstream infection (CRBSI) rates were low and similar (2.8 vs. 2.6/1000 catheter days, p = 0.93). Exit site infections were significantly lower in the PICC group (7.4 vs. 23.1/1000 catheter days, p = 0.01). Bleeding events occurred more frequently in PICCs (13.9 vs. 6.4/1000 catheter days, p = 0.14) but were mostly minor. More patients in the CICC group received at least one platelet transfusion before insertion (36.8% vs. 16.9%, p = 0.03). Mechanical complications and symptomatic thromboses were rare in both groups. CONCLUSION: PICCs were associated with longer dwell times and fewer local infections, without increased risk of CRBSIs or thrombosis. These findings suggest that PICCs may help optimize supportive care in clinically stable patients undergoing AML induction chemotherapy.