Spectrum and Clinical Correlates of Central Venous Line Complications in Pediatric Hematopoietic Stem Cell Transplantation Recipients: A Comparative Analysis of Infectious versus Non-Infectious Events in A Single-Center, Retrospective Study
نویسندگان
1 Pediatric Surgery Research Center, Research Institute for Children Health, Mofid Children’s Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran
2 Pediatric Congenital Hematologic Disorders Research Center, Research Institute for Children Health, Shahid Beheshti University of Medical Sciences, Tehran, Iran
3 Pediatric Congenital Hematologic Disorders Research Center, Mofid Children’s Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran
4 Pediatric Infections Research Center, Research Institute for Children Health, Mofid Children’s Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran
5 Department of Pediatric Surgery, School of Medicine, Mofid Children’s Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran
6 Mofid Children’s Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran
7 Department of Pediatric Infectious Disease, School of Medicine, Pediatric Infections Research Center, Research Institute for Children Health, Mofid Children’s Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran
8 Shahid Beheshti University of Medical Sciences, Tehran, Iran
9 Department of Pediatric Hematology & Oncology, School of Medicine, Mofid Children’s Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran
10 Department Of Pediatric Hematology & Oncology, School of Medicine, Pediatric Congenital Hematologic Disorders Research Center, Research Institute for Children Health, Mofid Children's Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran
doi
10.22074/cellj.2026.2059832.1850چکیده
Objective: Central venous lines (CVLs) are indispensable in pediatric hematopoietic stem cell transplantation (HSCT)but carry a high risk of complications. This study aimed to compare the clinical, microbiological, and outcome profilesbetween pediatric HSCT recipients who developed infectious versus non-infectious CVL complications.Materials and Methods: In this single-center, retrospective study, from a total of 228 pediatric HSCT recipients (2015-2024),this analysis focused on comparing the 76 patients who developed CVL-related infectious complications with the 74 patientswho had non-infectious complications. Demographic, clinical, and transplant-related variables were analyzed. Bivariateanalyses (Chi-square/Fisher’s exact tests) were used to explore unadjusted associations between these variables andcomplication type.Results: In this study, infection was the most common complication (50.7% of all events). Patients with infectiouscomplications more frequently had a non-malignant underlying disease (63.2% vs. 40.5%; OR=2.51, P=0.006) and hadundergone allogeneic transplantation (89.5% vs. 58.1%; OR=6.33, P<0.001) compared to those with non-infectiouscomplications. A higher proportion of patients with infectious complications had received a reduced-intensity conditioning(RIC) regimen (48.7% vs. 32.4%), although this difference did not reach statistical significance after multiple-comparisonadjustment (P=0.031).Conclusion: This within-group comparative study characterizes a subgroup of pediatric HSCT recipients with infectiousCVL complications, defined by non-malignant underlying disease, allogeneic transplantation, and RIC. These exploratoryfindings describe clinically relevant patterns among complicated cases and provide a hypothesis-generating basis forfuture analytical studies to investigate causal risk factors.
