Hemorrhagic cystitis following hematopoietic stem cell transplantation: incidence, risk factors and association with CMV reactivation and graft-versus-host disease

Xu, Lei; Zhang, Hongyu; Huang, Xiao‐Jun; Liu, Kai-Yan; Liu, Dai‐Hong; Han, Wei; Chen, Huan; Chen, Yuhong; Gao, Zhiyong; Zhang, Yao-chen; Lu, Dao‐Pei

doi:10.1097/00029330-200710010-00004

Cited by 32 publications

(25 citation statements)

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“…The overall incidence of EOHC in the current study is slightly higher than that reported by Lee et al (2003) (19% versus 11%), potentially because of the current study containing more patients receiving unrelated transplantation (60% versus 21%) because HLA-MUD stem cell donor was demonstrated as a risk factor for HC (El-Zimaity et al, 2004;Xu et al, 2007). A trend toward a higher incidence of EOHC among patients who had a HLA-MUD (71%) was registered compared with patients with sibling donors (23%), suggesting that more intense immunosuppression may contribute to an increased risk of HC, as previously suggested by Xu et al (2007) and El-Zimaity et al (2004).…”

Section: Discussioncontrasting

confidence: 68%

“…The incidence of HC in BMT recipients varies from 18%-40% (El-Zimaity et al, 2004;Hadjibabaie et al, 2008;Tsuboi et al, 2003) and, in 4%-8% of cases, HC was severe (Korkmaz, Topal, & Oter, 2007;Lee et al, 2003;Xu et al, 2007). This wide range of reported incidence and severity of complications may be partially from a different definition criteria adopted by researchers and different types of prophylaxis for graft-versus-host disease (GVHD).…”

mentioning

confidence: 99%

“…This wide range of reported incidence and severity of complications may be partially from a different definition criteria adopted by researchers and different types of prophylaxis for graft-versus-host disease (GVHD). In addition, some studies showed HC incidence only in the overall period (Bedi et al, 1995;Hadjibabaie et al, 2008;Hassan et al, 2007;Shepherd et al, 1991;Vose et al, 1993), and others considered EOHC and LOHC separately (El-Zimaity et al, 2004;Lee et al, 2003;Tsuboi et al, 2003;Xu et al, 2007).…”

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confidence: 99%

“…Cytomegalovirus (Hassan et al, 2007;Xu et al, 2007) and BK virus (Bedi et al, 1995;Erard et al, 2005;Miller et al, 2011) reactivation, GVHD (Hadjibabaie et al, 2008Lee et al, 2003;Xu et al, 2007), high-dose antithymocyte globulin (Fu et al, 2013), and donor type (El-Zimaity et al, 2004;Xu et al, 2007) have been recognized as LOHC-related risk factors, but data are conflicting. Bedi et al (1995) and Turkeri et al (1995) did not find any association between HC and GVHD.…”

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confidence: 99%

“…Previous reports (El-Zimaity et al, 2004;Lee et al, 2003;Tsuboi et al, 2003;Xu et al, 2007) mainly focused on the incidence and risk factors of HC. Very few studies (Hadjibabaie et al, 2008;Shepherd et al, 1991;Turkeri et al, 1995;Vose et al, 1993) explored preventive measures for EOHC.…”

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confidence: 99%

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Preventive Measures for Cyclophosphamide-Related Hemorrhagic Cystitis in Blood and Bone Marrow Transplantation: An Italian Multicenter Retrospective Study

Gonella

Pasquale²,

Palese³

2015

CJON

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Thirty-one patients (19.6%) developed EOHC. One hundred and forty-seven patients (93%) given high-dose CY were treated with hyperhydration combined with 2-mercaptoethane sulphonate (mesna) and diuresis alkalinization, and only 51 (32.3%) patients were preventively catheterized and received continuous bladder irrigation (CBI). By univariate analysis, prophylactic urethral catheterization and CBI did not decrease EOHC incidence questioning if these measures were to be routinely recommended. Previous studies showed increased discomfort and urinary tract infection in catheterized patients; therefore, nurses may fulfill an important role in balancing the benefits and harms of preventive catheterization and CBI in patients who received BMT conditioning including high-dose CY.

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confidence: 68%

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confidence: 99%

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confidence: 99%

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confidence: 99%

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confidence: 99%

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Preventive Measures for Cyclophosphamide-Related Hemorrhagic Cystitis in Blood and Bone Marrow Transplantation: An Italian Multicenter Retrospective Study

Gonella

Pasquale²,

Palese³

2015

CJON

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Cytomegalovirus is a potential risk factor for late‐onset hemorrhagic cystitis following allogeneic hematopoietic stem cell transplantation

Han

Liu

et al. 2013

American J Hematol

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Late-onset hemorrhagic cystitis (LOHC) is a common complication following allogeneic hematopoietic stem cell transplantation (allo-HSCT) and is primarily associated with viral infection. We prospectively quantified cytomegalovirus (CMV), BK virus (BKV), and adenovirus in urine and plasma using Q-RT-PCR in 50 consecutive patients to define the relationship between virus and LOHC. Of the 50 patients, 21 developed LOHC at a median of 29 days (range 4-64 days), with a cumulative incidence of 42% (67.1%). The cumulative incidence of LOHC on day 100 in patients with and without CMV viremia (prior to or at the onset of LOHC) were 56.3% (68.9%) and 16.7% (69.1%) (P 5 0.018), respectively, and it was 59.3% (69.8%) and 21.7% (68.8%) in patients with and without CMV viruria (prior to or at the onset of LOHC) (P 5 0.021), respectively. The cumulative incidence of LOHC was also higher in patients with a plasma BKV load increased 3 log 10 or with a urine BKV load increased 4 log 10 than those without the increase (P < 0.001). Only one patient with LOHC was tested positive for ADV. Both the univariate and multivariate analyses showed that CMV viremia (HR 5 3.461, 95% CI: 1.005-11.922, P 5 0.049) and a plasma BKV load that was increased 3 log 10 (HR 5 10.705, 95%CI: 2.469-46.420, P 5 0.002) were independent risk factors for the development of LOHC. We conclude that both CMV viremia and an increase of plasma BKV are independent risk factors for LOHC. And the role of CMV viremia was firstly demonstrated.

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Viral infection in bone marrow transplants: Is JC virus involved?

Mischitelli

Fioriti

Anzivino

et al. 2009

Journal of Medical Virology

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Hemorrhagic cystitis is characterized by hematuria due to inflammation of the bladder. In bone marrow transplants, this disease is linked to the infection by human polyomavirus BK, whereas the role of the human polyomavirus JC is unclear. The transcriptional control regions of both viruses contain important cellular transcription factor binding sites that undergo rearrangement process generating suitable variants that could be more active for viral replication and for the onset of hemorrhagic cystitis. In this study urine obtained from seven patients with bone marrow transplant were examined. Polyomavirus genomes were quantified by PCR and viral loads were compared. The transcriptional regions of both viruses were amplified and sequenced to determine the presence of variants. Subtypes of polyomaviruses were determined by amplification and sequencing of the viral protein 1 region. The results showed that four of seven patients were positive for BK DNA, two of seven patients had BK and JC DNA and one of seven had JC DNA. Positive samples were amplified and sequenced successively for transcriptional regions. The viral archetype was always found in both viruses. Finally, typing showed that BK virus subtype I infected patients with BK, whereas JC virus genotype IA and genotype 1B were found in patients infected with JC. The data suggest that new and different approaches are required to improve the morbidity and mortality caused by polyoma-associated hemorrhagic cystitis, since it known that BK virus is involved in the onset of hemorrhagic cystitis, whereas the role of JC virus should be investigated further.

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Hemorrhagic cystitis following hematopoietic stem cell transplantation: incidence, risk factors and association with CMV reactivation and graft-versus-host disease

Cited by 32 publications

References 10 publications

Preventive Measures for Cyclophosphamide-Related Hemorrhagic Cystitis in Blood and Bone Marrow Transplantation: An Italian Multicenter Retrospective Study

Preventive Measures for Cyclophosphamide-Related Hemorrhagic Cystitis in Blood and Bone Marrow Transplantation: An Italian Multicenter Retrospective Study

Cytomegalovirus is a potential risk factor for late‐onset hemorrhagic cystitis following allogeneic hematopoietic stem cell transplantation

Viral infection in bone marrow transplants: Is JC virus involved?

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