Comparison of intravenous or intravesical cidofovir in the treatment of <scp>BK</scp> polyomavirus‐associated hemorrhagic cystitis following adult allogeneic stem cell transplantation—A systematic review

Schneidewind, Laila; Neumann, Thomas; Schmidt, Christian A.; Krüger, William

doi:10.1111/tid.12914

Cited by 24 publications

(23 citation statements)

References 31 publications

(91 reference statements)

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“…Here, cidofovir was studied extensively; however, it is very nephrotoxic itself. Therefore, application in patients who already suffer from kidney failure is not reasonable [ 23 ]. Our results suggest that targeting the immune response to BKPyV might be a promising approach for further studies.…”

Section: Discussionmentioning

confidence: 99%

Significance of BK Polyomavirus in Long-Term Survivors after Adult Allogeneic Stem Cell Transplantation

Neumann

Peters

Kranz

et al. 2021

Biology

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Background: Allogeneic stem cell transplantation (aSCT) is a common treatment for a variety of hematological diseases. Advances in transplantation practices have led to an increasing number of long-term aSCT survivors, but data about health status and late complications are sparse. This analysis focusses on kidney function and urological complications in this population. Methods: This study is a prospective unicentric non-interventional trial. Before starting the study, we obtained the approval of the local ethics review board. Furthermore, the study was registered at WHO Clinical Trial Registry. The study protocol is available via UTN. Results: We were able to include 33 patients with a mean age of 60.5 years (SD 11.1). The median survival time following allogeneic stem cell transplantation was 9.0 years (IQR 8.5–13.0). Five patients (15.2%) had BKPyV viruria with mean 218.3 (SD 674.2) copies/mL. BKPyV viruria was significantly linked to pre-existing chronic kidney failure (p = 0.019), creatine > 100 µmol/L (p < 0.001), and cystatin c > 1.11 mg/L (p = 0.021), respectively. We were not able to identify a single risk factor for BKPyV viruria in univariate or multivariate Cox regression. Conclusions: BKPyV-associated nephropathy might be one reason for impaired kidney function in long-term survivors of aSCT.

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Section: Discussionmentioning

confidence: 99%

Significance of BK Polyomavirus in Long-Term Survivors after Adult Allogeneic Stem Cell Transplantation

Neumann

Peters

Kranz

et al. 2021

Biology

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“…Approximately 30% of non-kidney transplant paediatric patients receiving intravenous cidofovir for adenovirus infections developed nephrotoxicity and the risk appears to be dose dependent [5]. Up to 50% of patients develop nephrotoxicity when intravenous cidofovir is used in haematopoietic stem cell transplant patients [6]. In our review (Supplementary data), 3 of 13 kidney transplant recipients (23.1%) developed worsening of renal function after the administration of intravenous cidofovir for adenovirus infections and 5 cases (38.5%) had a >30% increase in serum creatinine from baseline after the completion of treatment.…”

Section: Discussionmentioning

confidence: 99%

“…Intravesical cidofovir has also been used for the treatment of polyomavirus-associated haemorrhagic cystitis in haematopoietic stem cell transplant patients. In a systematic review, intravesical cidofovir was found to be more effective and have a lower risk of nephrotoxicity than intravenous cidofovir [6].…”

Section: Discussionmentioning

confidence: 99%

The use of intravesical cidofovir for the treatment of adenovirus-associated haemorrhagic cystitis in a kidney transplant recipient

Tan

Thien

et al. 2019

Clinical Kidney Journal

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Adenovirus is an important cause of haemorrhagic cystitis in kidney transplant recipients. The optimal treatment for adenovirus-associated haemorrhagic cystitis (AAHC) is unknown. Intravenous cidofovir may be effective, but nephrotoxicity is a major concern. The use of intravesical cidofovir for viral haemorrhagic cystitis has been reported in haematopoietic stem cell transplant recipients and may be associated with a lower risk of nephrotoxicity, but its use has not been reported in kidney transplant recipients. We report the use of intravesical cidofovir for the treatment of AAHC in a kidney transplant recipients, along with a review of the literature.

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“…However, there is only weak evidence for the use of cidofovir as an in vivo anti-BKV drug. 16 Also, the pronounced nephrotoxicity limits its use particularly in renal transplantation. 10 In addition, cidofovir-resistance has been noted for multiple viruses.…”

Section: Introductionmentioning

confidence: 99%

In vitro anti-BK polyomavirus activity of imidazo[1,2-c]pyrimidine and pyrimido[1,6 a]pyrimidine derivatives

Solomyannyi¹,

Mitiukhin²,

Prichard³

et al. 2020

10.5267/j.ccl

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Five imidazo[1,2-c]pyrimidine and pyrimido[1,6-a]pyrimidine derivatives were designed, synthesized and evaluated for their antiproliferative activity and cytotoxicity. Primary bioassays in vitro showed that two of five synthesized compounds, 6-benzyl-8-(methylsulfonyl)-2,6-dihydroimidazo[1,2-c]pyrimidin-5(3H)-one, and 9-(methylsulfonyl)-7propyl-2,3,4,7-tetrahydro-6H-pyrimido[1,6-a]pyrimidin-6-one possessed potent antiviral activity against BKV (EC50: 0.66 μM and 0.96, respectively). The selectivity index of these compounds is similar to that of cidofovir. Although antiviral activity was evident in secondary assays, significant virus inhibition occurred at or near the cytotoxic concentration (SI90=1). Here we show that substituted pyrimidine derivatives are a promising structure class of chemical compounds for the development of antiviral drugs against BKV infections. Hence these compounds may be taken as lead compounds for further development of novel antimicrobial and anticancer agents.

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Comparison of intravenous or intravesical cidofovir in the treatment of BK polyomavirus‐associated hemorrhagic cystitis following adult allogeneic stem cell transplantation—A systematic review

Abstract: There is only weak evidence for the use of CDV. The intravesical admission route should be further investigated because of a good toxicity profile.

Cited by 24 publications

References 31 publications

Significance of BK Polyomavirus in Long-Term Survivors after Adult Allogeneic Stem Cell Transplantation

Significance of BK Polyomavirus in Long-Term Survivors after Adult Allogeneic Stem Cell Transplantation

The use of intravesical cidofovir for the treatment of adenovirus-associated haemorrhagic cystitis in a kidney transplant recipient

In vitro anti-BK polyomavirus activity of imidazo[1,2-c]pyrimidine and pyrimido[1,6 a]pyrimidine derivatives

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