Intravesical bacillus Calmette-Guérin instillation therapy for non-muscle-invasive bladder cancer following solid organ transplantation

Swietek, Natalia; Waldert, Matthias; Susani, Martin; Schatzl, Georg; Klatte, Tobias

doi:10.1007/s00508-013-0343-1

Cited by 12 publications

(5 citation statements)

References 19 publications

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“…Because of the theoretically high risk of side effects such as sepsis in immunocompromised patients, BCG instillation is contraindicated in transplant recipients. However, there are a few case reports indicating that BCG instillation was performed without complication in such patients 22,23. According to our matching analysis comparing the treatment outcomes of bladder cancer, the progression rates of bladder cancer were significantly higher in KT recipients.…”

Section: Discussionmentioning

confidence: 73%

Incidences and oncological outcomes of urothelial carcinoma in kidney transplant recipients

Yu¹,

Lee²,

Kang³

et al. 2018

CMAR

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PurposeWe investigated to determine if there is an increased rate of urothelial carcinoma (UC) in kidney transplant (KT) recipients and to compare oncological outcomes of UC in KT recipients with non-KT patients.Patients and methodsAmong 2,186 patients who underwent KT in our institute, nine patients developed UC after KT in our center. Age-standardized rates (ASRs) were calculated to compare incidence rates of UC between KT patients and the general population. Additional five patients who underwent KT at other hospitals and received UC treatment at our center were included, thus a total of 14 KT patients were compared with non-KT patients in the aspect of the treatment outcomes of bladder cancer and upper urinary tract UC (UTUC) by using generalized estimating equation (GEE).ResultsThe ASRs of bladder cancer and UTUC in KT recipients were 25.5 and 129.5 times higher than that of the general population. Although there was no difference in bladder cancer-specific survival rates (P-value 0.1186), however, progression rates of bladder cancer were significantly higher in KT recipients with a relative risk of 10.53 (P-value 0.0481). There was no significant difference in UTUC recurrence, progression, and specific survival rate (P-values 0.8915, 0.8806, and 0.8116, respectively).ConclusionIncidence of UC was much higher in KT recipients than the general population. Treatment outcomes for UC in KT recipients were not inferior to those of non-KT patients, except for the progression of bladder cancer. Special attention should be paid to screening and treatment of UC in KT recipients.

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Section: Discussionmentioning

confidence: 73%

Incidences and oncological outcomes of urothelial carcinoma in kidney transplant recipients

Yu¹,

Lee²,

Kang³

et al. 2018

CMAR

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“…The incidence of adverse BCG effects in immunocompromised patients is unclear because of a paucity of data in the literature. However, several recent studies following immunocompromised patients who received intravesical BCG have reported similar incidences of adverse reactions compared to non‐immunocompromised patients . Likewise, bladder cancer response rates to intravesical BCG after 6‐months among immunocompromised patients is also similar to non‐immunocompromised patients .…”

Section: Discussionmentioning

confidence: 86%

“…However, several recent studies following immunocompromised patients who received intravesical BCG have reported similar incidences of adverse reactions compared to non-immunocompromised patients. [15][16][17][18][19][20][21][22] Likewise, bladder cancer response rates to intravesical BCG after 6-months among immunocompromised patients is also similar to non-immunocompromised patients. 21 The largest case series by Herr and Dalgbani followed 45 immunosuppressed patients, including 12 solid organ transplant patients treated with intravesical BCG for bladder cancer, and found that BCG therapy was well-tolerated with no reports of BCG-induced sepsis.…”

Section: Discussionmentioning

confidence: 99%

DisseminatedMycobacterium bovisinfection post‐kidney transplant following remote intravesicalBCGtherapy for bladder cancer

Ziegler

Gibson

et al. 2018

Transplant Infectious Dis

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Intravesical Bacillus Camlette-Guérin (BCG) is the treatment of choice for non-muscle invasive bladder cancer, and has been used successfully for over 40 years. A rare and potentially fatal complication of intravesical BCG therapy is BCG-induced sepsis. We report a rare case in which a patient with end-stage renal disease secondary to chronic granulomatous interstitial nephritis underwent remote, pre-transplant intravesical BCG treatment for high-grade non-invasive papillary bladder carcinoma. The patient subsequently received a deceased donor kidney transplant 5 years after BCG therapy, with thymoglobulin induction therapy and standard triple maintenance immunosuppression. Two years post-transplant, he developed BCG-induced sepsis confirmed by cultures from urine, blood, and left native kidney biopsy. He died from disseminated BCG-induced sepsis and failure of his renal allograft. This case highlights the potential adverse reactions associated with intravesical BCG therapy that may occur years after bladder cancer therapy is completed, and should heighten physician awareness for BCG-related infections during pre-transplant assessment and post-transplant care of solid organ transplants recipients.

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“… 1 In particular, high‐grade non‐muscle‐invasive bladder cancer was reported to be the most frequent among types of bladder cancer, and most of the cases occur following kidney transplantation. 2 Herein, we report a case of bladder cancer that emerged following bilateral lung transplantation and bone marrow transplantation.…”

Section: Introductionmentioning

confidence: 99%

A case of bladder cancer after bilateral lung transplantation following bone marrow transplantation

Arai,

Goto,

Sazuka

et al. 2023

IJU Case Reports

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IntroductionThe incidence of bladder cancer following transplantation is high; however, no previous studies have reported the development of bladder cancer following bone marrow and bilateral lung transplantations.Case presentationA 42‐year‐old man who was followed for bilateral lung transplantation due to chronic graft‐versus‐host disease following bone marrow transplantation complained of gross hematuria. Transurethral resection of the bladder tumor was performed for cT1N0M0 bladder cancer. On the following night, he experienced severe respiratory failure and was intubated. He was discharged on postoperative day 32 with the introduction of home oxygen therapy. The pathological diagnosis was invasive urothelial carcinoma, high‐grade, pT1, with urothelial carcinoma in situ. Further treatment could not be performed because of his poor performance status and immunosuppressive state.ConclusionVigorous screening for bladder cancer coexisting with other malignancies should be performed for transplant recipients for the early diagnosis and prompt treatment of a relatively aggressive bladder cancer.

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Intravesical bacillus Calmette-Guérin instillation therapy for non-muscle-invasive bladder cancer following solid organ transplantation

Cited by 12 publications

References 19 publications

Incidences and oncological outcomes of urothelial carcinoma in kidney transplant recipients

Incidences and oncological outcomes of urothelial carcinoma in kidney transplant recipients

DisseminatedMycobacterium bovisinfection post‐kidney transplant following remote intravesicalBCGtherapy for bladder cancer

A case of bladder cancer after bilateral lung transplantation following bone marrow transplantation

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