Spectrum and Clinical Correlates of Central Venous Line Complications in Pediatric Hematopoietic Stem Cell Transplantation Recipients: A Comparative Analysis of Infectious versus Non-Infectious Events in A Single-Center, Retrospective Study.

Abstract

Objective: Central venous lines (CVLs) are indispensable in pediatric hematopoietic stem cell transplantation (HSCT) but carry a high risk of complications. This study aimed to compare the clinical, microbiological, and outcome profiles between pediatric HSCT recipients who developed infectious versus non-infectious CVL complications.

Materials and methods: In this single-center, retrospective study, from a total of 228 pediatric HSCT recipients (2015-2024), this analysis focused on comparing the 76 patients who developed CVL-related infectious complications with the 74 patients who had non-infectious complications. Demographic, clinical, and transplant-related variables were analyzed. Bivariate analyses (Chi-square/Fisher's exact tests) were used to explore unadjusted associations between these variables and complication type.

Results: In this study, infection was the most common complication (50.7% of all events). Patients with infectious complications more frequently had a non-malignant underlying disease (63.2% vs. 40.5%; OR=2.51, P=0.006) and had undergone allogeneic transplantation (89.5% vs. 58.1%; OR=6.33, P<0.001) compared to those with non-infectious complications. A higher proportion of patients with infectious complications had received a reduced-intensity conditioning (RIC) regimen (48.7% vs. 32.4%), although this difference did not reach statistical significance after multiple-comparison adjustment (P=0.031).

Conclusion: This within-group comparative study characterizes a subgroup of pediatric HSCT recipients with infectious CVL complications, defined by non-malignant underlying disease, allogeneic transplantation, and RIC. These exploratory findings describe clinically relevant patterns among complicated cases and provide a hypothesis-generating basis for future analytical studies to investigate causal risk factors.