Pediatric CNS Tumor Patients Have Significantly Lower Requirement of Tissue Plasminogen Activator for Episodes of Central Venous Catheter Dysfunction Compared With Other Pediatric Oncology Patients: Results of a Population-based Cohort Study
Purpose: Central venous catheters (CVCs) are an important component of care delivery in pediatric oncology patients. However, CVC dysfunction is a common problem. Tissue plasminogen activator (tPA) is often administered to re-establish function, however, specific experience in pediatric patients wit...
Published in: | Journal of Pediatric Hematology/Oncology |
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Online Access: | http://dx.doi.org/10.1097/mph.0000000000001670 https://journals.lww.com/10.1097/MPH.0000000000001670 |
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crovidcr:10.1097/mph.0000000000001670 2023-11-05T03:43:34+01:00 Pediatric CNS Tumor Patients Have Significantly Lower Requirement of Tissue Plasminogen Activator for Episodes of Central Venous Catheter Dysfunction Compared With Other Pediatric Oncology Patients: Results of a Population-based Cohort Study Howie, Chelsea Crooks, Bruce Moorehead, Paul Kulkarni, Ketan 2019 http://dx.doi.org/10.1097/mph.0000000000001670 https://journals.lww.com/10.1097/MPH.0000000000001670 en eng Ovid Technologies (Wolters Kluwer Health) Journal of Pediatric Hematology/Oncology volume 42, issue 7, page e623-e626 ISSN 1077-4114 Oncology Hematology Pediatrics, Perinatology and Child Health journal-article 2019 crovidcr https://doi.org/10.1097/mph.0000000000001670 2023-10-06T10:47:38Z Purpose: Central venous catheters (CVCs) are an important component of care delivery in pediatric oncology patients. However, CVC dysfunction is a common problem. Tissue plasminogen activator (tPA) is often administered to re-establish function, however, specific experience in pediatric patients with central nervous system (CNS) tumors is lacking. The goal of this study was to investigate the CVC experience and use of tPA for episodes of CVC dysfunction in pediatric patients with CNS tumors in comparison with other patients. Methods: Medical records of all pediatric oncology patients from the 4 Atlantic provinces in Canada (Nova Scotia, New Brunswick, Prince Edward Island, and Newfoundland and Labrador) were reviewed. Data collected included demographics, treatment, details of CVCs along with CVC dysfunction, and tPA use. Results: The cohort consisted of 1152 pediatric oncology patients, 222 (19.3%) of whom had CNS tumors. CVC dysfunction requiring tPA administration occurred in 12 (5.4%) of patients with CNS tumors compared with 182 (19.6%) of patients with non-CNS tumors ( P =0.0001). Multivariate logistic regression analysis showed that administration of tPA for CVC dysfunction was 2.5 times more likely in patients with non-CNS tumors than those with CNS tumors ( P =0.012; 95% confidence interval, 1.3-4.9). Conclusions: Our study showed that pediatric patients with CNS tumors require significantly less frequent administration of tPA for episodes of CVC dysfunction than patients with non-CNS tumors after adjusting for confounding factors. Hypotheses for this include: potential biologic differences of tumors, the role of the blood-brain barrier, or systematic differences in intensity of treatments. Article in Journal/Newspaper Newfoundland Prince Edward Island Ovid (via Crossref) Journal of Pediatric Hematology/Oncology 42 7 e623 e626 |
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Ovid (via Crossref) |
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crovidcr |
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English |
topic |
Oncology Hematology Pediatrics, Perinatology and Child Health |
spellingShingle |
Oncology Hematology Pediatrics, Perinatology and Child Health Howie, Chelsea Crooks, Bruce Moorehead, Paul Kulkarni, Ketan Pediatric CNS Tumor Patients Have Significantly Lower Requirement of Tissue Plasminogen Activator for Episodes of Central Venous Catheter Dysfunction Compared With Other Pediatric Oncology Patients: Results of a Population-based Cohort Study |
topic_facet |
Oncology Hematology Pediatrics, Perinatology and Child Health |
description |
Purpose: Central venous catheters (CVCs) are an important component of care delivery in pediatric oncology patients. However, CVC dysfunction is a common problem. Tissue plasminogen activator (tPA) is often administered to re-establish function, however, specific experience in pediatric patients with central nervous system (CNS) tumors is lacking. The goal of this study was to investigate the CVC experience and use of tPA for episodes of CVC dysfunction in pediatric patients with CNS tumors in comparison with other patients. Methods: Medical records of all pediatric oncology patients from the 4 Atlantic provinces in Canada (Nova Scotia, New Brunswick, Prince Edward Island, and Newfoundland and Labrador) were reviewed. Data collected included demographics, treatment, details of CVCs along with CVC dysfunction, and tPA use. Results: The cohort consisted of 1152 pediatric oncology patients, 222 (19.3%) of whom had CNS tumors. CVC dysfunction requiring tPA administration occurred in 12 (5.4%) of patients with CNS tumors compared with 182 (19.6%) of patients with non-CNS tumors ( P =0.0001). Multivariate logistic regression analysis showed that administration of tPA for CVC dysfunction was 2.5 times more likely in patients with non-CNS tumors than those with CNS tumors ( P =0.012; 95% confidence interval, 1.3-4.9). Conclusions: Our study showed that pediatric patients with CNS tumors require significantly less frequent administration of tPA for episodes of CVC dysfunction than patients with non-CNS tumors after adjusting for confounding factors. Hypotheses for this include: potential biologic differences of tumors, the role of the blood-brain barrier, or systematic differences in intensity of treatments. |
format |
Article in Journal/Newspaper |
author |
Howie, Chelsea Crooks, Bruce Moorehead, Paul Kulkarni, Ketan |
author_facet |
Howie, Chelsea Crooks, Bruce Moorehead, Paul Kulkarni, Ketan |
author_sort |
Howie, Chelsea |
title |
Pediatric CNS Tumor Patients Have Significantly Lower Requirement of Tissue Plasminogen Activator for Episodes of Central Venous Catheter Dysfunction Compared With Other Pediatric Oncology Patients: Results of a Population-based Cohort Study |
title_short |
Pediatric CNS Tumor Patients Have Significantly Lower Requirement of Tissue Plasminogen Activator for Episodes of Central Venous Catheter Dysfunction Compared With Other Pediatric Oncology Patients: Results of a Population-based Cohort Study |
title_full |
Pediatric CNS Tumor Patients Have Significantly Lower Requirement of Tissue Plasminogen Activator for Episodes of Central Venous Catheter Dysfunction Compared With Other Pediatric Oncology Patients: Results of a Population-based Cohort Study |
title_fullStr |
Pediatric CNS Tumor Patients Have Significantly Lower Requirement of Tissue Plasminogen Activator for Episodes of Central Venous Catheter Dysfunction Compared With Other Pediatric Oncology Patients: Results of a Population-based Cohort Study |
title_full_unstemmed |
Pediatric CNS Tumor Patients Have Significantly Lower Requirement of Tissue Plasminogen Activator for Episodes of Central Venous Catheter Dysfunction Compared With Other Pediatric Oncology Patients: Results of a Population-based Cohort Study |
title_sort |
pediatric cns tumor patients have significantly lower requirement of tissue plasminogen activator for episodes of central venous catheter dysfunction compared with other pediatric oncology patients: results of a population-based cohort study |
publisher |
Ovid Technologies (Wolters Kluwer Health) |
publishDate |
2019 |
url |
http://dx.doi.org/10.1097/mph.0000000000001670 https://journals.lww.com/10.1097/MPH.0000000000001670 |
genre |
Newfoundland Prince Edward Island |
genre_facet |
Newfoundland Prince Edward Island |
op_source |
Journal of Pediatric Hematology/Oncology volume 42, issue 7, page e623-e626 ISSN 1077-4114 |
op_doi |
https://doi.org/10.1097/mph.0000000000001670 |
container_title |
Journal of Pediatric Hematology/Oncology |
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42 |
container_issue |
7 |
container_start_page |
e623 |
op_container_end_page |
e626 |
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1781702106630062080 |