# Assessment of the feasibility and safety of totally implantable venous access port to collect blood samples in pediatric patients with acute lymphoblastic leukemia

## TL;DR

This study shows that using a totally implantable venous access port is as safe and effective as traditional blood draws for pediatric leukemia patients.

## Contribution

Demonstrates TIVAP's feasibility and safety as an alternative to peripheral venipuncture in pediatric ALL patients.

## Key findings

- No significant differences in MTX plasma concentration between TIVAP and peripheral venipuncture groups.
- Blood indicators and coagulation function were comparable between the two methods.
- No adverse events were observed in the TIVAP group.

## Abstract

To assess the feasibility and safety of utilizing a totally implantable venous access port (TIVAP) to collect venous blood sample as an alternative to peripheral venipuncture in pediatric patients with acute lymphoblastic leukemia (ALL).

The study implemented a self-contemporaneous control design. Fifty pediatric patients diagnosed with ALL were recruited from a tertiary children’s hospital between January to November 2024 in Hangzhou, China. They underwent high-dose methotrexate (HD-MTX) chemotherapy. For each participant, both TIVAP and peripheral venipuncture were used to collect blood samples. The MTX concentration, levels of blood indicators, coagulation function and adverse events were measured and compared between TIVAP and peripheral venipuncture groups.

The mean age was 6.1 (standard deviation: 2.9) years. No statistically significant difference in MTX plasma concentration was observed between TIVAP and peripheral venipuncture group at 24, 48, and 72 hours in all patients and subgroups of low, intermediate and high risk (p values > 0.05). In addition, we did not observe statistically significant differences (p values > 0.05) in levels of blood indicators (i.e., serum creatinine, alanine aminotransferase, white blood count, hemoglobin, platelet, pH, serum potassium, sodium, chloride, and lactate) and coagulation function profiles (i.e., prothrombin time, activated partial thromboplastin time, thrombin time, fibrinogen and plasma D-dimer) between TIVAP and peripheral venipuncture group. No adverse events, such as hemolysis or coagulation issues, were observed in the TIVAP group.

TIVAP had a comparable feasibility and safety with peripheral venipuncture, and may be used as an alternative to collect blood sample in pediatric patients with ALL.