The use of indwelling tunneled pleural catheters for recurrent pleural effusions in patients with hematologic malignancies: A multicenter study

Christopher R. Gilbert, Hans J Lee, Joseph H. Skalski, Fabien Maldonado, Momen Wahidi, Philip J. Choi, Jamie Bessich, Daniel Sterman, A. Christine Argento, Samira Shojaee, Jed A. Gorden, Candice L. Wilshire, David Feller-Kopman, Ricardo Ortiz, Bareng A.S. Nonyane, Lonny Yarmus

Research output: Contribution to journalArticle

Abstract

BACKGROUND: Malignant pleural effusion is a common complication of advanced malignancies. Indwelling tunneled pleural catheter (IPC) placement provides effective palliation but can be associated with complications, including infection. In particular, hematologic malignancy and the associated immunosuppressive treatment regimens may increase infectious complications. This study aimed to review outcomes in patients with hematologic malignancy undergoing IPC placement. METHODS: A retrospective multicenter study of IPCs placed in patients with hematologic malignancy from January 2009 to December 2013 was performed. Inclusion criteria were recurrent, symptomatic pleural effusion and an underlying diagnosis of hematologic malignancy. Records were reviewed for patient demographics, operative reports, and pathology, cytology, and microbiology reports. RESULTS: Ninety-one patients (mean ± SD age, 65.4 ± 15.4 years) were identified from eight institutions. The mean × SD in situ dwell time of all catheters was 89.9 ± 127.1 days (total, 8,160 catheter-days). Seven infectious complications were identified, all of the pleural space. All patients were admitted to the hospital for treatment, with four requiring additional pleural procedures. Two patients died of septic shock related to pleural infection. CONCLUSIONS: We present, to our knowledge, the largest study examining clinical outcomes related to IPC placement in patients with hematologic malignancy. An overall 7.7% infection risk and 2.2% mortality were identified, similar to previously reported studies, despite the significant immunosuppression and pancytopenia oft en present in this population. IPC placement appears to remain a reasonable clinical option for patients with recurrent pleural effusions related to hematologic malignancy.

Original languageEnglish (US)
Pages (from-to)752-758
Number of pages7
JournalChest
Volume148
Issue number3
DOIs
StatePublished - Sep 1 2015

Fingerprint

Hematologic Neoplasms
Pleural Effusion
Multicenter Studies
Catheters
Infection
Malignant Pleural Effusion
Pancytopenia
Immunosuppressive Agents
Septic Shock
Microbiology
Immunosuppression
Cell Biology
Retrospective Studies
Demography
Pathology
Mortality
Therapeutics
Population

ASJC Scopus subject areas

  • Pulmonary and Respiratory Medicine
  • Critical Care and Intensive Care Medicine
  • Cardiology and Cardiovascular Medicine

Cite this

The use of indwelling tunneled pleural catheters for recurrent pleural effusions in patients with hematologic malignancies : A multicenter study. / Gilbert, Christopher R.; Lee, Hans J; Skalski, Joseph H.; Maldonado, Fabien; Wahidi, Momen; Choi, Philip J.; Bessich, Jamie; Sterman, Daniel; Argento, A. Christine; Shojaee, Samira; Gorden, Jed A.; Wilshire, Candice L.; Feller-Kopman, David; Ortiz, Ricardo; Nonyane, Bareng A.S.; Yarmus, Lonny.

In: Chest, Vol. 148, No. 3, 01.09.2015, p. 752-758.

Research output: Contribution to journalArticle

Gilbert, CR, Lee, HJ, Skalski, JH, Maldonado, F, Wahidi, M, Choi, PJ, Bessich, J, Sterman, D, Argento, AC, Shojaee, S, Gorden, JA, Wilshire, CL, Feller-Kopman, D, Ortiz, R, Nonyane, BAS & Yarmus, L 2015, 'The use of indwelling tunneled pleural catheters for recurrent pleural effusions in patients with hematologic malignancies: A multicenter study', Chest, vol. 148, no. 3, pp. 752-758. https://doi.org/10.1378/chest.14-3119
Gilbert, Christopher R. ; Lee, Hans J ; Skalski, Joseph H. ; Maldonado, Fabien ; Wahidi, Momen ; Choi, Philip J. ; Bessich, Jamie ; Sterman, Daniel ; Argento, A. Christine ; Shojaee, Samira ; Gorden, Jed A. ; Wilshire, Candice L. ; Feller-Kopman, David ; Ortiz, Ricardo ; Nonyane, Bareng A.S. ; Yarmus, Lonny. / The use of indwelling tunneled pleural catheters for recurrent pleural effusions in patients with hematologic malignancies : A multicenter study. In: Chest. 2015 ; Vol. 148, No. 3. pp. 752-758.
@article{896b46fb41804db1a82345aa703cc4fd,
title = "The use of indwelling tunneled pleural catheters for recurrent pleural effusions in patients with hematologic malignancies: A multicenter study",
abstract = "BACKGROUND: Malignant pleural effusion is a common complication of advanced malignancies. Indwelling tunneled pleural catheter (IPC) placement provides effective palliation but can be associated with complications, including infection. In particular, hematologic malignancy and the associated immunosuppressive treatment regimens may increase infectious complications. This study aimed to review outcomes in patients with hematologic malignancy undergoing IPC placement. METHODS: A retrospective multicenter study of IPCs placed in patients with hematologic malignancy from January 2009 to December 2013 was performed. Inclusion criteria were recurrent, symptomatic pleural effusion and an underlying diagnosis of hematologic malignancy. Records were reviewed for patient demographics, operative reports, and pathology, cytology, and microbiology reports. RESULTS: Ninety-one patients (mean ± SD age, 65.4 ± 15.4 years) were identified from eight institutions. The mean × SD in situ dwell time of all catheters was 89.9 ± 127.1 days (total, 8,160 catheter-days). Seven infectious complications were identified, all of the pleural space. All patients were admitted to the hospital for treatment, with four requiring additional pleural procedures. Two patients died of septic shock related to pleural infection. CONCLUSIONS: We present, to our knowledge, the largest study examining clinical outcomes related to IPC placement in patients with hematologic malignancy. An overall 7.7{\%} infection risk and 2.2{\%} mortality were identified, similar to previously reported studies, despite the significant immunosuppression and pancytopenia oft en present in this population. IPC placement appears to remain a reasonable clinical option for patients with recurrent pleural effusions related to hematologic malignancy.",
author = "Gilbert, {Christopher R.} and Lee, {Hans J} and Skalski, {Joseph H.} and Fabien Maldonado and Momen Wahidi and Choi, {Philip J.} and Jamie Bessich and Daniel Sterman and Argento, {A. Christine} and Samira Shojaee and Gorden, {Jed A.} and Wilshire, {Candice L.} and David Feller-Kopman and Ricardo Ortiz and Nonyane, {Bareng A.S.} and Lonny Yarmus",
year = "2015",
month = "9",
day = "1",
doi = "10.1378/chest.14-3119",
language = "English (US)",
volume = "148",
pages = "752--758",
journal = "Chest",
issn = "0012-3692",
publisher = "American College of Chest Physicians",
number = "3",

}

TY - JOUR

T1 - The use of indwelling tunneled pleural catheters for recurrent pleural effusions in patients with hematologic malignancies

T2 - A multicenter study

AU - Gilbert, Christopher R.

AU - Lee, Hans J

AU - Skalski, Joseph H.

AU - Maldonado, Fabien

AU - Wahidi, Momen

AU - Choi, Philip J.

AU - Bessich, Jamie

AU - Sterman, Daniel

AU - Argento, A. Christine

AU - Shojaee, Samira

AU - Gorden, Jed A.

AU - Wilshire, Candice L.

AU - Feller-Kopman, David

AU - Ortiz, Ricardo

AU - Nonyane, Bareng A.S.

AU - Yarmus, Lonny

PY - 2015/9/1

Y1 - 2015/9/1

N2 - BACKGROUND: Malignant pleural effusion is a common complication of advanced malignancies. Indwelling tunneled pleural catheter (IPC) placement provides effective palliation but can be associated with complications, including infection. In particular, hematologic malignancy and the associated immunosuppressive treatment regimens may increase infectious complications. This study aimed to review outcomes in patients with hematologic malignancy undergoing IPC placement. METHODS: A retrospective multicenter study of IPCs placed in patients with hematologic malignancy from January 2009 to December 2013 was performed. Inclusion criteria were recurrent, symptomatic pleural effusion and an underlying diagnosis of hematologic malignancy. Records were reviewed for patient demographics, operative reports, and pathology, cytology, and microbiology reports. RESULTS: Ninety-one patients (mean ± SD age, 65.4 ± 15.4 years) were identified from eight institutions. The mean × SD in situ dwell time of all catheters was 89.9 ± 127.1 days (total, 8,160 catheter-days). Seven infectious complications were identified, all of the pleural space. All patients were admitted to the hospital for treatment, with four requiring additional pleural procedures. Two patients died of septic shock related to pleural infection. CONCLUSIONS: We present, to our knowledge, the largest study examining clinical outcomes related to IPC placement in patients with hematologic malignancy. An overall 7.7% infection risk and 2.2% mortality were identified, similar to previously reported studies, despite the significant immunosuppression and pancytopenia oft en present in this population. IPC placement appears to remain a reasonable clinical option for patients with recurrent pleural effusions related to hematologic malignancy.

AB - BACKGROUND: Malignant pleural effusion is a common complication of advanced malignancies. Indwelling tunneled pleural catheter (IPC) placement provides effective palliation but can be associated with complications, including infection. In particular, hematologic malignancy and the associated immunosuppressive treatment regimens may increase infectious complications. This study aimed to review outcomes in patients with hematologic malignancy undergoing IPC placement. METHODS: A retrospective multicenter study of IPCs placed in patients with hematologic malignancy from January 2009 to December 2013 was performed. Inclusion criteria were recurrent, symptomatic pleural effusion and an underlying diagnosis of hematologic malignancy. Records were reviewed for patient demographics, operative reports, and pathology, cytology, and microbiology reports. RESULTS: Ninety-one patients (mean ± SD age, 65.4 ± 15.4 years) were identified from eight institutions. The mean × SD in situ dwell time of all catheters was 89.9 ± 127.1 days (total, 8,160 catheter-days). Seven infectious complications were identified, all of the pleural space. All patients were admitted to the hospital for treatment, with four requiring additional pleural procedures. Two patients died of septic shock related to pleural infection. CONCLUSIONS: We present, to our knowledge, the largest study examining clinical outcomes related to IPC placement in patients with hematologic malignancy. An overall 7.7% infection risk and 2.2% mortality were identified, similar to previously reported studies, despite the significant immunosuppression and pancytopenia oft en present in this population. IPC placement appears to remain a reasonable clinical option for patients with recurrent pleural effusions related to hematologic malignancy.

UR - http://www.scopus.com/inward/record.url?scp=84941670828&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84941670828&partnerID=8YFLogxK

U2 - 10.1378/chest.14-3119

DO - 10.1378/chest.14-3119

M3 - Article

C2 - 25789576

AN - SCOPUS:84941670828

VL - 148

SP - 752

EP - 758

JO - Chest

JF - Chest

SN - 0012-3692

IS - 3

ER -