Clinical Edge

Summaries of Must-Read Clinical Literature, Guidelines, and FDA Actions

This Newly-Tested Tool Predicts PICC-DVT Risk

J Thromb Haemost; ePub 2017 Sep 13; Chopra, et al

A newly-tested tool can estimate the risk of deep vein thrombosis (DVT) in patients with peripherally inserted central catheters (PICCs), according to a study involving more than 23,000 individuals. Participants with upper extremity DVT were divided into 4 risk classes. The Michigan PICC-DVT Risk Score was then tested and validated to determine factors linked with PICC-DVT. Among the results:

  • 2% of patients developed PICC-DVT.
  • Risk factors included DVT history, multi-lumen PICC, active cancer, presence of another central venous catheter, and white blood cell count >12,000.
  • Thrombosis rates were 0.9% for class I, 1.6% for class II, 2.7% for class III, and 4.7% for class IV.
  • Predicted probabilities were 0.9%, 1.5%, 2.6%, and 4.5%, respectively.
  • Patients in class II were 50% more likely to develop PICC-DVT than those in class I.
  • Patients in classes III and IV were nearly 3 and >5 times more likely, respectively.


Chopra V, Kaatz S, Conlon A, et al. The Michigan Risk Score to predict peripherally inserted central catheter-associated thrombosis. [Published online ahead of print September 13, 2017]. J Thromb Haemost. doi:10.1111/jth.13794.

This Week's Must Reads

Immune system changes play a role in AML relapse, Christopher MJ et al. N Engl J Med. 2018 Oct 31. doi: 10.1056/NEJMoa1808777.

Haploidentical allo-HCT possible even in relapsed myeloma, Sahebi F, et al. Biol Blood Marrow Transplant. 2018 Sep 20. pii: S1083-8791(18)30575-5.

Venetoclax plus HMA studied in AML, DiNardo C et al. Blood. 2018 Oct 25. doi: 10.1182/blood-2018-08-868752.

The role of PTPN22 R620W in CLL, Leukemia & Lymphoma 2018

Must Reads in Thrombosis

Cardiovascular risks in hemophilia A, Humphries TJ et al. Adv Med Sci. 2018;63(2):329-33

Genetic key to bleeding risk with warfarin, Perera MA et al. JAMA. 2018 Oct 23. doi: 10.1001/jama.2018.14955

Complications in EPOCH-R versus R-CHOP, David RJ et al. Clin Lymphoma Myeloma Leuk. 2018 Aug 29. doi: 10.1016/j.clml.2018.08.014

Gene sequencing sheds light on outcomes in MPN, Grinfeld J et al. N Engl J Med. 2018;379:1416-30

Obesity lowers risk of death in PE patients, Khan Z et al. CHEST. 2018 Oct. doi: 10.1016/j.chest.2018.08.919