Dynamics of <scp>BKP</scp>yV reactivation and risk of hemorrhagic cystitis after allogeneic hematopoietic stem cell transplantation

Höller, Konstantin; Fabeni, Lavinia; Herling, Marco; Scheid, Christof; Knops, Elena; Lübke, Nadine; Kaiser, Rolf; Pfister, Herbert; Cristanziano, Veronica Di

doi:10.1111/ejh.12895

Cited by 12 publications

(7 citation statements)

References 42 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Erard et al [17] showed in a multivariate model that plasma viral load of more than 10 4 copies/mL was associated with developing HC in allogeneic hematopoietic stem cell transplant recipients. Höller et al [33] could not detect a predictive cutoff for plasma viral load in a recent study, but they indicated that the presence of viremia might itself predict BKV-associated morbidity. Interestingly, we detected a lower threshold (2 log 10 ) for BK-related HC in our prospective study, which might be related to the limited number of patients included in our study.…”

Section: Discussionmentioning

confidence: 95%

Prospective Analysis of Hemorrhagic Cystitis and BK Viremia in Allogeneic Hematopoietic Stem Cell Transplantation

Atilla

Ateş

Uslu

et al. 2019

Tjh

View full text Add to dashboard Cite

Objective: BK virus (BKV) infection has been shown to be related to hemorrhagic cystitis (HC) in allogeneic hematopoietic stem cell transplantation (allo-HSCT). There are conflicting data regarding the association between BKV titers in plasma and clinical disease as well as the risk factors for BKV-related HC. Our aim is to study the risk factors and relationship with plasma BK viral load for development of HC in a prospective analysis. Materials and Methods: We prospectively evaluated 59 patients who received allo-HSCT between 2014 and 2016 by quantitative BK virus polymerase chain reaction (PCR) (Altona Diagnostics, Germany) from blood samples at days 0, 30, 60, and 90 after allo-HSCT. The patients were monitored for signs and symptoms of HC. Results: HC was diagnosed in 22 patients (37%) at a mean of 100 days (range: 0-367 days). In multivariate analysis, the usage of cyclophosphamide (sub-distribution hazard ratio [sdHR]: 7.82, confidence interval [CI]: 1.375-39.645, p=0.02), reactivated CMV (sdHR: 6.105, CI: 1.614-23.094, p=0.008), and positive BKV viremia (sdHR: 2.15, CI: 1.456-22.065, p=0.01) significantly increased the risk of developing HC. Patients with higher viral loads at day 30 and day 60 were diagnosed with more severe HC (p<0.001). Median BK viral loads of >101.5 copies/mL at day 0 (sensitivity 0.727, specificity 0.875), >98.5 copies/mL at day 30 (sensitivity 0.909, specificity 0.875), and >90.0 copies/mL at day 60 (sensitivity 0.909, specificity 0.875) were indicative of HC. Conclusion: Our study showed that administration of cyclophosphamide, CMV reactivation, and BK virus positivity were associated with HC. Plasma BK virus PCR titers at days 0, 30, and 60 after transplant were sensitive tools for predicting clinically proven HC.

show abstract

Section: Discussionmentioning

confidence: 95%

Prospective Analysis of Hemorrhagic Cystitis and BK Viremia in Allogeneic Hematopoietic Stem Cell Transplantation

Atilla

Ateş

Uslu

et al. 2019

Tjh

View full text Add to dashboard Cite

show abstract

“…While the risk factors for the development of BKPyV-HC identified in previous studies were not always consistent, most studies found a strong association between the detection of BKPyV in the urine and serum and development of BKPyV-HC. [13][14][15][24][25][26][27][28][29] In addition, the timing of the development of BKPyV viruria, the viral load, and an increase in viremia have been correlated with the development of BKPyV-HC. Patients have been reported to develop HC as early as 34 days after allogeneic SCT.…”

Section: Discussionmentioning

confidence: 99%

“…12 It has been demonstrated that high-level BKPyV viruria and viremia have been found to be predictive factors for post-allogeneic SCT BKPyV-HC in both pediatric and adult populations. [13][14][15] Other studies have indicated that plasma BKPyV monitoring did not demonstrate early detection or rising plasma BKPyV levels predicts for BKHC. 16 While it is increasingly clear that there is still no consensus on whether urine or plasma levels of BKPyV should be tested, what levels are predictive of BKPyV-HC, and when testing should be conducted, it has been demonstrated that underlying malignancy, conditioning regimen, and HLA match status showed significant associations with BKPyV replication.…”

Section: Introductionmentioning

confidence: 99%

“…Recently, the 6th European Conference on Infections in Leukemia (ECIL‐6) BKPyV‐HC working group did not recommend monitoring of BKPyV in adult patients who have undergone allogeneic SCT 12 . It has been demonstrated that high‐level BKPyV viruria and viremia have been found to be predictive factors for post‐allogeneic SCT BKPyV‐HC in both pediatric and adult populations 13‐15 . Other studies have indicated that plasma BKPyV monitoring did not demonstrate early detection or rising plasma BKPyV levels predicts for BKHC 16 .…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Development and validation of a risk assessment tool for BKPyV Replication in allogeneic stem cell transplant recipients

Abudayyeh

Lin

Abdelrahim

et al. 2020

Transplant Infectious Dis

View full text Add to dashboard Cite

Background: BK polymavirus (BKPyV), a member of the family Polyomaviridae, is associated with increased morbidity and mortality in allogeneic stem cell transplant recipients. Methods: In our previous retrospective study of 2477 stem cell transplant patients, BKPyV replication independently predicted chronic kidney disease and poor survival. In this study, using the same cohort, we derived and validated a risk grading system to identify patients at risk of BKPyV replication after transplantation in a user-friendly modality. We used 3 baseline variables (conditioning regimen, HLA match status, and underlying cancer diagnosis) that significantly predicted BKPyV replication in our initial study in a subdistribution hazard model with death as a competing risk. We also developed a nomogram of the hazard model as a visual aid. The AUC of the ROC of the risk-score-only model was 0.65. We further stratified the patients on the basis of risk score into low-, moderate-, and high-risk groups. Results: The total risk score was significantly associated with BKPyV replication (P < .0001). At 30 days after transplantation, the low-risk (score ≤ 0) patients had a 9% chance of developing symptomatic BKPyV replication, while the high-risk (score ≥ 8) of the population had 56% of developing BKPyV replication. We validated the risk score using a separate cohort of 1478 patients. The AUC of the ROC of the risk-score-only model was 0.59. Both the total risk score and 3-level risk variable were significantly associated with BKPyV replication in this cohort (P < .0001). Conclusions: This grading system for the risk of symptomatic BKPyV replication may help in early monitoring and intervention to prevent BKPyV-associated morbidity, mortality, and kidney function decline.

show abstract

“…Diagnosis is confirmed by quantitatively measuring viral copies in plasma or urine. It has been shown that being an asymptomatic carrier of BK virus after HSCT is a risk factor for AKI, especially when viremia is detectable [7].…”

Section: Ivyspringmentioning

confidence: 99%

Acute Kidney Injury in Oncology Patients

Wang

Diao

et al. 2020

J. Cancer

View full text Add to dashboard Cite

With rapid progress in cancer diagnosis and treatment in the last two decades, outcomes in oncological patients have improved significantly. However, the incidence of acute kidney injury (AKI) in this population has also increased significantly. AKI complicates many aspects of patients' care and adversely affects their prognoses; thus, accurately diagnosing the risk factors for AKI ensures appropriate management. AKI may be caused by pre-renal, intrinsic renal, and post-renal reasons, as well as for combined reasons. This review summarizes the potential etiologies of AKI according to the three classifications. For each underlying cause of AKI, the cancer itself and/or cancer treatment may contribute to a patient developing AKI. Therefore, we present disease-and treatment-related factors for each cause category, with special focus on immune checkpoint inhibitors, which are being used increasingly more often. It is important for nephrology services to be knowledgeable to provide the best level of care.

show abstract

Dynamics of BKPyV reactivation and risk of hemorrhagic cystitis after allogeneic hematopoietic stem cell transplantation

Abstract: Monitoring of BKPyV-DNA by real-time PCR after initiation of conditioning, regularly performed in clinical practice, can be a crucial tool for the early identification of patients with higher risk of BKPyV-associated HC.

Cited by 12 publications

References 42 publications

Prospective Analysis of Hemorrhagic Cystitis and BK Viremia in Allogeneic Hematopoietic Stem Cell Transplantation

Prospective Analysis of Hemorrhagic Cystitis and BK Viremia in Allogeneic Hematopoietic Stem Cell Transplantation

Development and validation of a risk assessment tool for BKPyV Replication in allogeneic stem cell transplant recipients

Acute Kidney Injury in Oncology Patients

Contact Info

Product

Resources

About