The use of peripheral intravenous catheters (PIV) for lymphoma patients receiving anthracycline-based chemotherapy: A multicenter real-world analysis (RWA).

Abstract

e13567 Background: Given a potential risk of extravasation with vesicants and irritants, central venous catheters (CVCs), such as port-a-cath or peripherally inserted central catheters, are commonly utilized for the administration of anthracycline-based chemotherapy. However, CVC placement can result in treatment delay, increased risk of deep vein thrombosis and infection (Luan D. ASCO 2025), malfunction, and increased financial and travel toxicity due in part to frequent flushing requirements. Furthermore, there are a paucity of data regarding the safety of PIV for lymphoma (Lym)-based therapy. This multicenter RWA examined the use and associated complications of PIVs to administer anthracycline-based chemotherapy. Methods: We conducted a retrospective RWA across 7 US centers for patients (pts) ages ³18 years (yrs) with Lym who received anthracycline therapy with a cyclophosphamide, doxorubicin, vincristine and prednisone (CHOP) or doxorubicin, bleomycin, vinblastine, dacarbazine (ABVD)-based regimen through PIV access between 2010 to 2024. Detailed baseline characteristics and safety data were obtained. Standard definitions of extravasation and other complications were used (Jackson-Rose J. CJON 2017). Results: 501 pts were included with median age 59 yrs (IQR 41-71), 55% male, ECOG 0-1 89%, and stage 3-4 in 44%. Types of Lym were: 47% diffuse large B-cell Lym (DLBCL)/high-grade Lym, 30% Hodgkin Lym, 10% T-cell Lym, 9% indolent or mantle cell Lym and 4% B-cell Lym NOS. Overall, 71% of pts received CHOP-based therapy and 29% an ABVD-based regimen. 68% of all pts completed chemotherapy via PIV. Among these, the total number of treatment cycles given were 2,016 and there were 2,525 associated unique treatment-day infusions of anthracycline-based chemotherapy delivered via PIV. The table includes detailed information of all PIV-associated complications. Altogether, there was 1 documented case of possible extravasation. This was a 73 yr-old woman with DLBCL receiving CHOP who developed pain, erythema, induration and blisters at the IV site after receiving anthracycline. The pt received DMSO, warm compress and pain medication. Complete resolution of symptoms were seen in 1 week. There was no vasculature or tissue damage identified. Conclusions: In this RWA of Lym pts receiving CHOP or ABVD-based therapy over a 15-yr period, use of PIV was effective and associated with a low risk of complications. Moreover, extravasation was rare with 1 reported potential case (i.e., 0.2% of pts treated via PIV and 0.04% of all infusion treatments). PIV complications (%) N=2,525 treatment-day infusions. Extravasation 1 (0.04) Malfunction 4 (0.2) Infiltration 7 (0.3) Pain/tenderness 38 (1.5) Erythema at IV site 22 (0.9) Induration/hardness/swelling at IV site 11 (0.3) Phlebitis/cellulitis at IV site 7 (0.3) Thrombosis at IV site 1 (0.04)