Clinical effectiveness of hyperbaric oxygen therapy for BK-virus-associated hemorrhagic cystitis after allogeneic bone marrow transplantation

Savva-Bordalo, Joana; Vaz, Carlos Pinho; Sousa, Marisa; Branca, Rosa T.; Campilho, Fernando; Resende, R; Baldaque, Inês; Camacho, Óscar; Campos, António

doi:10.1038/bmt.2011.228

Cited by 43 publications

(44 citation statements)

References 29 publications

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“…It induced proliferation of fibroblasts, promoted angiogenesis of capillaries, and stimulated the recovery of urothelium [4,5]. The most convenient group of patients for treatment with HBO consists of patients with BK virusassociated HC after allogenic human stem cell transplantations [2]. In this paper, we present 5 patients after alloHSCT from a matched unrelated donor (MUD) with symptoms of HC successfully treated with HBO.…”

Section: Introductionmentioning

confidence: 96%

“…The onset of HC can occur within 1 week of the conditioning regimen and is often connected with the toxic metabolite of cyclophosphamide. The late clinical course of HC has been associated with certain viruses, such as adenoviruses I and II (ADV I, II), polyoma virus BK (BKV), JC viruses and cytomegalovirus [2]. The symptoms of HC may be caused by a defect in the inflammatory response and increased permeability of the glycosaminoglycan layer, which covers the bladder mucosa, forming a physiological barrier.…”

Section: Introductionmentioning

confidence: 99%

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The use of hyperbaric oxygen therapy in the treatment of hemorrhagic cystitis after allogeneic stem cell transplantation from an unrelated donor

et al. 2015

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Hemorrhagic cystitis (HC) is a diffuse inflammation of the bladder of an infectious or non-infectious etiology, causing bleeding of the bladder mucosa. There are no explicit guidelines defining the appropriate treatment of HC. Hyperbaric oxygen therapy (HBO) is a non-invasive method involving the use of 100 % oxygen under increased pressure, which penetrates to poorly perfused areas. The most appropriate group for treatment with HBO is patients with BK virus-associated HC after allogenic human stem cell transplantation (alloHSCT). In this report, we present five patients after alloHSCT from a matched unrelated donor with symptoms of HC successfully treated with HBO. All patients received therapy with 100 % oxygen in a hyperbaric chamber at 2.5 atmospheres for 60 min, delivered 5 days per week. Complete response with resolution of pain and hematuria, as well as eradication of viral load, was achieved by all the patients after a mean of 13 sessions (range 11-30) of HBO. These data indicate that HBO therapy is sufficient and effective in the treatment of HC, and represents a well-tolerated procedure with good clinical and laboratory results after ineffective primary treatment.

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Section: Introductionmentioning

confidence: 96%

Section: Introductionmentioning

confidence: 99%

The use of hyperbaric oxygen therapy in the treatment of hemorrhagic cystitis after allogeneic stem cell transplantation from an unrelated donor

et al. 2015

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“…8 Hyperbaric oxygen therapy also has been used successfully for treatment of mucormycosis and leukoencephalopathy secondary to radiotherapy in leukemic patients. 9,10 Hyperbaric oxygen therapy also induces apoptosis in T-cell leukemia cell lines in vitro and may be an adjuvant treatment option in the future.…”

Section: Hyperbaric Oxygen Therapy For Hemorrhagic Cystitismentioning

confidence: 99%

Untitled

Gökçe

Akçay²,

Tuğcu³

et al. 2014

Exp Clin Transplant

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“…Apparently the hyperbaric oxygen stimulates mucosal repair in the urinary bladder. In a retrospective study, 16 patients with PyVHC received 100% oxygen in a hyperbaric chamber at 2.1 atmospheres for 90 min, 5 days per week for between 4 and 84 times and 15 patients showed complete resolution of hematuria (181). There are also reports on intravesicular instillation of formalin and aluminium to stop bleeding (182,183), but formalin is known to give different side effects like ureteric stenosis and renal parenchymal damage while aluminium can cause intoxication especially in children (182).…”

Section: Pyvhcmentioning

confidence: 99%

The human polyomavirus BK (BKPyV): virological background and clinical implications

Rinaldo¹,

Tylden²,

Sharma³

2013

APMIS

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Polyomavirus BK (BKPyV) infects most people subclinically during childhood and establishes a lifelong infection in the renourinary tract. In most immunocompetent individuals, the infection is completely asymptomatic, despite frequent episodes of viral reactivation with shedding into the urine. In immunocompromised patients, reactivation followed by high-level viral replication can lead to severe disease: 1-10% of kidney transplant patients develop polyomavirus-associated nephropathy (PyVAN) and 5-15% of allogenic hematopoietic stem cell transplant patients develop polyomavirus-associated haemorrhagic cystitis (PyVHC). Other conditions such as ureteric stenosis, encephalitis, meningoencephalitis, pneumonia and vasculopathy have also been associated with BKPyV infection in immunocompromised individuals. Although BKPyV has been associated with cancer development, especially in the bladder, definitive evidence of a role in human malignancy is lacking. Diagnosis of PyVAN and PyVHC is mainly achieved by quantitative PCR of urine and plasma, but also by cytology, immunohistology and electron microscopy. Despite more than 40 years of research on BKPyV, there is still no effective antiviral therapy. The current treatment strategy for PyVAN is to allow reconstitution of immune function by reducing or changing the immunosuppressive medication. For PyVHC, treatment is purely supportive. Here, we present a summary of the accrued knowledge regarding BKPyV.

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Clinical effectiveness of hyperbaric oxygen therapy for BK-virus-associated hemorrhagic cystitis after allogeneic bone marrow transplantation

Cited by 43 publications

References 29 publications

The use of hyperbaric oxygen therapy in the treatment of hemorrhagic cystitis after allogeneic stem cell transplantation from an unrelated donor

The use of hyperbaric oxygen therapy in the treatment of hemorrhagic cystitis after allogeneic stem cell transplantation from an unrelated donor

Untitled

The human polyomavirus BK (BKPyV): virological background and clinical implications

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