The frequency, severity, and risk factors of Hickman catheter-related complications in pediatric acute leukemia patients: A single-center experience from Bosnia and Herzegovina

Objectives: This study aimed to evaluate the frequency, severity, and risk factors associated with Hickman catheterrelated complications in pediatric patients with acute leukemia at a tertiary pediatric care center in Bosnia and Herzegovina. Patients and methods: This retrospective study was conducted with 88 pediatric patients (54 males, 34 females; mean age: 5.9±4.6 years; range, 0 to 18 years) diagnosed with acute leukemia who had Hickman catheters inserted between January 2019 and July 2024. Data on complication rates, types, and outcomes were collected. Results: A total of 91 Hickman central venous catheters were inserted in 88 children. The cohort included 60 (68%) children with acute lymphoblastic leukemia (ALL) and 28 (32%) children with acute myeloid leukemia 14 (AML). The median follow-up was 190 days (95% confidence interval, 160-212), spanning 12,644 catheter days. Complications occurred in 24 (27.3%) patients. Twelve (13.1%) of these were mechanical, seven (7.7%) were infectious, and five (5.5%) were thrombotic; the incidence rates were 0.8, 0.48, and 0.08 per 1,000 catheter days, respectively. Notably, AML patients had a higher complication rate (1.59 per 1,000 catheter days) compared to ALL patients (1.22 per 1,000 catheter days). Conclusion: Hickman catheter-related complications in pediatric leukemia patients are relatively common, with AML patients facing a higher risk. Understanding these complications can help improve patient management and outcomes.