Evaluation of the risk factors for <scp>BK</scp> virus‐associated hemorrhagic cystitis in pediatric bone marrow transplantation patients: Does <scp>post‐transplantation</scp> cyclophosphamide increase the frequency?

Ersoy, Gizem Zengin; Bozkurt, Ceyhun; Aksoy, Başak Adaklı; Öner, Özlem; Aydoğdu, Selime; Çipe, Funda; Sütçü, Murat; Özkaya, Ozan; Fışgın, Tunç

doi:10.1111/petr.14364

Cited by 4 publications

(3 citation statements)

References 19 publications

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“…In this regard, it has been reported that the rates of infection by BK virus and CMV reactivation are significantly lower in these groups. Particularly, in the study by Ersoy et al (2023) [ 37 ] the frequency of BK virus infection was 9.2% in the high donor compatibility whereas the frequency was higher in the mismatch (9.7%) and the haploidentical (19.3%) groups. Similar results were reported by Atay et al (2018) [ 36 ] where the frequency of BK virus infection was lower in the high donor compatibility group (31%) than in the mismatch and haploidentical groups (37.5% and 38.7%, respectively).…”

Section: Discussionmentioning

confidence: 99%

Infections and risk factors for infection-related mortality after pediatric allogeneic hematopoietic stem cell transplantation in Mexico: A single center retrospective study

Jiménez-Hernández,

Núñez-Enriquez,

Arellano-Galindo

et al. 2023

PLoS ONE

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Objective To identify the type of infections and risk factors for infection-related mortality (IRM) after allogeneic hematopoietic stem cell transplantation (HSCT). Methods Retrospective cohort study of patients <16 years of age treated in 2010–2019 was conducted. Unadjusted hazard ratios (HR) and adjusted hazard ratios (aHR) with 95% confidence intervals (95% CIs) were estimated using Cox regression. Cumulative incidence was calculated. Results Data for 99 pediatric patients were analyzed. The myeloablative conditioning was the most used regimen (78.8%) and the hematopoietic stem cell source was predominantly peripheral blood (80.8%). Primary graft failure occurred in 19.2% of patients. Frequency of acute graft-versus-host disease was 46.5%. Total of 136 infectious events was recorded, the most common of which were bacterial (76.4%) followed by viral infection (15.5%) and then fungal infection (8.1%). The best predictors for infection subtypes where the following: a) for bacterial infection (the age groups of 10.1–15 years: aHR = 3.33; 95% CI: 1.62–6.85 and. >15 years: aHR = 3.34; 95% CI: 1.18–9.45); b) for viral infection (graft versus host disease: aHR = 5.36; 95% CI: 1.62–17.68), however, for fungal infection statistically significant predictors were not identified. Related mortality was 30% (n = 12). Increased risk for infection-related mortality was observed in patients with unrelated donor and umbilical cord stem cells recipients (HR = 3.12; 95% CI: 1.00–9.85). Conclusions Frequencies of infections and infection-related mortality appear to be similar to those reported. Unrelated donors and stem cells from umbilical cord recipients were associated with a high risk of mortality.

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Section: Discussionmentioning

confidence: 99%

Infections and risk factors for infection-related mortality after pediatric allogeneic hematopoietic stem cell transplantation in Mexico: A single center retrospective study

Jiménez-Hernández,

Núñez-Enriquez,

Arellano-Galindo

et al. 2023

PLoS ONE

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“…In conclusion, until there is comprehensive evidence about the additive effects of postCy on GvHD control or superiority to ATG in MUD transplants, we suggest that postCy is not recommended in MUD pediatric transplants because of the risk of increased immunosuppression. Viral reactivations have been reported, including cytomegalovirus, Epstein Barr virus (11) and BKV-related grade 4 hemorrhage cystitis (14). Viral reactivations should be monitored closely and treated promptly.…”

Section: Discussionmentioning

confidence: 99%

Can Posttransplant Cycloposphamide Reduce the Risk of Graft vs Host Disease for Pediatric Fully Matched Non-Related Stem Cell Transplantation?

Aksoy,

Ersoy,

Oner

et al. 2023

Preprint

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Objective Post-transplant cyclophosphamide (postCy) is widely used as prophylaxis for graft-versus-host disease (GvHD) in haploidentical bone marrow transplantation and is being investigated in matched transplants for pediatric patients. The effect of postCy for prophylaxis of GvHD in pediatric, fully-matched, unrelated, peripheral blood stem cell transplantation (PBSCT) is described. Methods This was a retrospective clinical study of 110 pediatric patients diagnosed with malignant and non-malignant diseases who underwent PBSCT from matched unrelated donors (MUD). Fifty patients received 50 mg/kg/d cyclophosphamide on day +3 and +4, designated Group 1, while the remaining 60 (Group 2) did not receive postCy. All patients were given a regimen of standard immunosuppression. Results One hundred and ten patients younger than 18 years (73 males and 37 females) were followed-up for a median of two years after successful PBSCT. The incidence of grade II–IV and grade III–IV acute GvHD was 28% and 18% in Group 2 while in Group 1 these rates were 20% and 10%, respectively. The incidence of chronic GvHD was 8.3% for Group 2 and 4% in Group 1. Survival for >100 days was 87.2% overall, 86% in Group 1 and 89% in Group 2; similarly, overall survival in these three populations was 78%, 76% and 80%, respectively. None of these differences were significant. Conclusion Although postCy-transplant was shown to have advantages for unmatched and haploidentical PBSCT in adult patients, the findings of the present study suggest no effect in fully MUD PBSCT in children. There is a need for larger studies to confirm or refute these findings and, if shown to be robust, to investigate why there is this difference between pediatric and adult transplant patients.

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“…One of these complications is thromboembolic events, which can have various underlying causes ( 3 ). Additionally, patients undergoing HSCT may experience hemorrhagic complications, such as diffuse alveolar hemorrhage and hemorrhagic cystitis ( 4 , 5 ).…”

Section: Introductionmentioning

confidence: 99%

Efficacy and Safety of a DOAC Compared to Unfractionated Heparin and A Low Molecular Weight Heparin in the Prevention of Thromboembolism in Hematopoietic Stem Cell Transplant Recipients

Azimi,

Hajifathali,

Parkhideh

et al. 2024

Iran J Pharm Res

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Background: Hematopoietic stem cell transplantation (HSCT) patients are at risk of thromboembolic events, making thromboprophylaxis crucial. Objectives: This study aimed to compare apixaban, a direct factor Xa inhibitor (DOAC), with dalteparin and unfractionated heparin for thromboprophylaxis in HSCT recipients. The safety outcome included the assessment of hemorrhagic events. Methods: In this open-label randomized clinical trial, 182 HSCT recipients were divided into three groups: apixaban (n = 61, 2.5 mg two times a day), dalteparin (n = 59, 5000 IU daily), and unfractionated heparin (n = 62, 5000 IU twice daily). These anticoagulant regimens were administered after central vein catheterization and during hospitalization. The primary clinical outcome was the risk of thrombosis, and the secondary outcome was the rate of bleeding. Relevant laboratory results were analyzed using appropriate statistical tests. Results: Among the 61 patients in the apixaban group, six experienced thrombosis (9.83%), with four (6.65%) of them on anticoagulants. In the dalteparin group, three patients (5%) developed thrombosis, two of whom (3.38%) were on anticoagulants. In the heparin group, all four thrombosis cases (6.4%) occurred in patients on anticoagulants (P = 0.543 overall and P = 0.776 in anticoagulant users). Only two cases of bleeding were reported (1.09% overall), one in the dalteparin group (1.69%) and the other in the apixaban group (1.63%). Conclusions: Apixaban, dalteparin, and heparin demonstrated similar effectiveness in preventing thromboembolism in HSCT recipients. Furthermore, the comparison of bleeding rates across the study groups did not reveal significant differences. Larger studies with higher event rates may yield more precise conclusions.

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Evaluation of the risk factors for BK virus‐associated hemorrhagic cystitis in pediatric bone marrow transplantation patients: Does post‐transplantation cyclophosphamide increase the frequency?

Cited by 4 publications

References 19 publications

Infections and risk factors for infection-related mortality after pediatric allogeneic hematopoietic stem cell transplantation in Mexico: A single center retrospective study

Infections and risk factors for infection-related mortality after pediatric allogeneic hematopoietic stem cell transplantation in Mexico: A single center retrospective study

Can Posttransplant Cycloposphamide Reduce the Risk of Graft vs Host Disease for Pediatric Fully Matched Non-Related Stem Cell Transplantation?

Efficacy and Safety of a DOAC Compared to Unfractionated Heparin and A Low Molecular Weight Heparin in the Prevention of Thromboembolism in Hematopoietic Stem Cell Transplant Recipients

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