Safety of Cryopreserved Stem Cell Infusion through a Peripherally Inserted Central Venous Catheter

SIMPLE SUMMARY: Autologous and allogeneic hematopoietic stem cell transplantations (HSCTs) are considered the standard of care for many hematological and non-hematological malignancies. It is generally believed that cryopreserved hematopoietic stem cells should be administered rapidly to minimize their exposure to cytotoxic dimethyl sulfoxide (DMSO). A fast peripheral blood stem cell (PBSC) infusion rate is usually achieved through conventionally inserted central venous catheters (CICCs). Therefore, CICCs are widely used in PBSC transplantation settings. Nevertheless, their insertion may be associated with serious complications. Peripherally inserted central venous catheters (PICCs) are not associated with such complications but are rarely used in cryopreserved PBSC transplantation due to the presumption that prolonged PBSC infusion through the CICC would impair their viability. We demonstrated that prolonged PBSC infusion through the PICC has no effect on transplantation outcomes. Therefore, we suggest implementing PICCs in a cryopreserved transplantation setting, as PICCs are more comfortable for patients, easier to insert, cost-effective, and have fewer serious line-related complications. ABSTRACT: The management of patients undergoing stem cell transplantation requires a multipurpose central venous catheter (CVC) to facilitate drug administration, parenteral nutrition, transfusion of blood products, and collection of blood samples. Peripherally inserted central venous catheters (PICCs) appear to meet these requirements but are rarely used for stem cell infusion. We aimed to retrospectively assess the safety and feasibility of stem cell infusion through PICC and to evaluate its impact on transplantation kinetics. We retrospectively analyzed the outcomes of peripheral blood stem cell (PBSC) transplantation in patients receiving cryopreserved autologous or allogeneic PBSC by PICCs and compared the results with patients receiving transplants through a conventionally inserted central venous catheter (CICC). Despite statistically significant differences in CD34(+) dose, infusion rate, and total length of administration, the clinical outcomes of transplantation, exemplified by platelet and neutrophil engraftment, along with the length of hospitalization, were not affected by the prolonged infusion time and lower infusion velocity in the PICC group. Our study showed that the clinical outcomes of PBSC transplantation did not differ between the PICC and CICC groups, suggesting that both types of catheters can be implemented in a PBSC transplantation setting.