# Risk Factors for Unplanned Early Implantable Port Catheter Removal in Adult Leukemia/Lymphoma Patients: Cancer Type or Different Degrees of Cytopenia?

## TL;DR

This study finds that leukemia patients are more likely to have early implantable port removal than lymphoma patients, with cancer type being a key factor over blood cell levels.

## Contribution

The study identifies leukemia as a significant risk factor for unplanned early port removal, independent of cytopenia levels.

## Key findings

- Leukemia patients had a 4.5 times higher risk of unplanned early catheter removal compared to lymphoma patients.
- Patients with normal nutrition had a 75% lower risk of unplanned early catheter removal than those with malnutrition.
- Unplanned early catheter removal was associated with worse patient survival.

## Abstract

Port implantation is a simple surgical procedure typically done under local anesthesia. These vascular ports are designed to provide repeated vascular access for patients requiring intravenous fluids, drug delivery or blood transfusions. In hematologic cancers such as lymphoma and leukemia, distinct blood cells characteristics help determine whether the disease itself or varying types of cytopenia contribute to the risk of early port infection. Addressing this challenge is essential, as it can significantly influence patient outcomes. This highlights the importance of strategies aimed at preventing complications and optimizing patient care.

(1) Background: Implantable port catheters are vital for cancer treatment, but complications such as infections and mechanical failures pose challenges. Lymphoma and leukemia patients’ unique cellular abnormalities may influence these risks. This study aimed to determine whether the underlying disease or varying degrees of cytopenia increase the risk of unplanned early port removal. (2) Methods: We conducted a single institution retrospective study that included 368 patients with lymphoma or leukemia who received implantable venous access ports between January 2015 and December 2022. Propensity score matching was employed to compare patients with and without early removals. (3) Results: Univariate analysis revealed statistically significant differences between early and non-early port removal for cancer, hemoglobin, and PG-SGA scores. Cox proportional hazard analysis demonstrated that leukemia patients exhibited a 4.5 times higher risk for unplanned early catheter removal than lymphoma patients did (HR 4.589, 95% CI 1.377–15.299, p = 0.013), while patients with normal nutrition, based on the PS-SGA, demonstrated a 75% lower risk of unplanned early catheter removal than those with any degree of malnutrition did (HR 0.258, 95% CI 0.116–0575, p < 0.001). Unplanned early catheter removal negatively impacted patient survival. (4) Conclusions: The type of cancer, rather than individual cytopenias, is an independent factor influencing clinical outcomes in lymphoma and leukemia patients.