SynthesisEuropean journal of haematology2026
Central Venous Access Device Complications in Children With Leukemia: A Systematic Review and Meta-Analysis.
Synthesis in European journal of haematology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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4 authors.
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Abstract
backgroundChildren diagnosed with leukemia require prolonged central venous access for chemotherapy, transfusions, and supportive care. Due to their immunocompromised status, coagulopathies, and intensive treatment protocols, they may be at increased risk for central venous access device (CVAD)-related complications, including infection, thrombosis, and mechanical failure. This study aimed to quantify the incidence and characterize the nature of CVAD-associated complications in this high-risk pediatric population.
methodsA systematic review (1970-2025) was conducted using PRISMA guidelines, including studies describing CVAD-associated complications in children (≤ 18 years old) undergoing treatment for leukemia. The Risk of Bias in Non-Randomized Studies of Interventions (ROBINS-I) tool was used to assess the studies' quality. Meta-analysis and proportional meta-analysis for non-comparative studies (Freeman-Tukey transformation) using the random-effects model were conducted.
resultsSix databases were searched identifying 1126 articles: 1102 were excluded and 24 studies with 13 879 CVADs were included. CVAD-associated complications identified included: device failure 18.5% (95% CI 10.8-27.8), central line-associated bloodstream infection (CLABSI) 31.3% (95% CI 23.6-39.6), local infection 5.4% (95% CI 2.5-9.3), CVAD-associated venous thromboembolism (VTE) 5.2% (95% CI 2.9-8.3), dislodgement/migration 2.4% (95% CI 1.5-3.5), breakage/rupture 3% (95% CI 1.9-4.3), occlusion 5.3% (95% CI 1.5-11.2), wound dehiscence 4.4% (95% CI 2.2-7.3), and accidental removal 4.9% (95% CI 2.0-9.0). Tunneled central venous access devices (TCVADs) were associated with a higher proportion of complications when compared to totally implantable venous access devices (TIVADs).
conclusionDevice failure and CLABSI are the CVAD-associated complications with the highest incidence rates. Comparing CVAD subtypes, TCVADs may have a higher complication risk than TIVADs. Further large prospective studies with long-term follow-up are needed to investigate these findings and determine their impact on patient morbidity and mortality.
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