Comparison of the differences in port and catheter use in AML patients

Purpose: In this study, patients diagnosed with AML who used central venous catheters (Hickman and port catheters) as vascular access throughout diagnosis and treatment; To examine demographic data, laboratory parameters, central venous catheter-related complication rates, complication types, management of these complications and treatment results, compare them with the data of similar patient groups diagnosed with AML, and investigate whether all these parameters contribute to overall survival and disease-free survival. Materials and Methods: The anamnesis, demographic data, biochemical laboratory results and electronic file records of 76 patients diagnosed with AML who were followed in our Suleyman Demirel University Faculty of Medicine Hematology outpatient clinic and used a central venous catheter between January 2017 and January 2023 were retrospectively examined. As a result of the treatments received, patients who were cured and those who were not were determined. The effects of all examined parameters on overall survival and disease-free survival were examined with statistical analysis. Result: Of the 76 patients included in the study, 41 were women (53.9%) and 35 were men (46.1%). The age of the patients ranged from 24 to 92 years, and the average age was 69.1 years.. 55 (72.4%) patients were using Hickman catheter and 21 (27.6%) were using port. The LDH value of patients monitored with a Hickman catheter was higher compared to patients monitored with a port (p = 0.033). There were 39 (51.3%) patients with catheter infection and 37 (48.7%) patients with culture growth, and 22 (59.5%) of these patients had a Hickman catheter (p=0.014). Similarly, culture growth rates were higher in patients diagnosed with AML who had a Hickman catheter (p=0.030). Additionally, a weak positive correlation was detected between culture growth and catheter infection with the Port catheter (r=0.249, p=0.03; r=0.281, p=0.014, respectively). Cure status had a statistically significant effect on overall survival (p<0.001), and patients who were not cured were 21.96 times more at risk compared to those who were cured. Conclusion: In our study, there was no effect of the central venous access regimen and gender to be chosen for patients diagnosed with AML, age, but each increase in temperature increased the risk of poor overall survival by 1,023 times. Elevated serum LDH is noticeable in patients with a Hickman catheter and catheter-related infections were detected more frequently in patients with Hickman catheters compared to patients with port catheters. Additionally, cultures were obtained in patients with Hickman catheters. In CVCRI, preventable factors should be taken into consideration and great attention should be paid to hand hygiene and necessary antiseptic measures. No statistically significant relationship was found between leukocyte, CRP and procalcitonin values at the time of diagnosis and at the time of infection and the type of Central vascular access. It has been observed that each unit of total bilirubin and age increase increases the risk of poor overall survival by 1.265 times (1.265 and 1.023 times), respectively. The overall survival rate was 21.95 times higher in patients who were cured. In conclusion; It has been determined that port catheters are more preferable in terms of infectious complications compared to Hickman catheters in AML patients.