Abstract:Hemorrhagic cystitis (HC) is a common complication of allogeneic hematopoietic stem cell transplantation (HSCT). The incidence is about 7% to 68%, and some patients have to suffer a long period of frequent, urgent, and painful urination, which brings great pain. This study aimed to analyze risk factors of HC and its effect on patient survival. We collected the medical records of 859 patients who underwent HSCT at our hospital between August 2016 and August 2020. Patients with and without HC were matched using … Show more
“…We noticed most bleedings were HC, which was considered to be related with virus infections, immunologic injury or bladder mucosa injury caused by chemotherapy. 31 Notably, three cases of severe hemorrhage (≥grade 3) in Arm A and three cases in Arm B were hematuria, which were inevitably aggravated with the low platelet level.…”
Conditioning therapy is an essential procedure prior to hematopoietic stem cell transplant (HSCT), imposing a great impact on the outcomes of recipients. We performed a prospective randomized controlled trial to assess the outcome of HSCT recipients with myeloid malignancies after receiving the conditioning therapy consisting of modified BUCY (mBUCY), N‐acetyl‐L‐cysteine (NAC), and decitabine. Enrolled patients were randomly allocated to either Arm A (decitabine, day −12 to −10; NAC, day −9 to +30; mBUCY, day −9 to −2), or Arm B (mBUCY regimen followed by stem cells infusion). Seventy‐six patients in Arm A and 78 patients in Arm B were finally evaluated. The results showed platelet recovery accelerate in Arm A, with more patients achieving a platelet count of ≥50 × 109/L than Arm B at day +30 and +60 (p = .004 and .043, respectively). The cumulative incidence of relapse is 11.8% (95% CI 0.06–0.22) in Arm A, and 24.4% (95% CI 0.16–0.35) in Arm B (p = .048). The estimated 3‐year overall survival rate was 86.4% (±4.4%) and 79.9% (±4.7%) in 2 arms, respectively (p = .155). EFS at 3 years was 79.2% (±4.9%) in Arm A and 60.0% (±5.9%) in Arm B (p = .007). Intracellular reactive oxygen species (ROS) level was found to be reversely correlated with platelet recovery, and fewer patients in Arm A displayed excessive ROS within hematopoietic progenitor cells compared to Arm B. In conclusion, the addition of decitabine and NAC to mBUCY is a feasible and promising conditioning therapy for myeloid malignancies patients.
“…We noticed most bleedings were HC, which was considered to be related with virus infections, immunologic injury or bladder mucosa injury caused by chemotherapy. 31 Notably, three cases of severe hemorrhage (≥grade 3) in Arm A and three cases in Arm B were hematuria, which were inevitably aggravated with the low platelet level.…”
Conditioning therapy is an essential procedure prior to hematopoietic stem cell transplant (HSCT), imposing a great impact on the outcomes of recipients. We performed a prospective randomized controlled trial to assess the outcome of HSCT recipients with myeloid malignancies after receiving the conditioning therapy consisting of modified BUCY (mBUCY), N‐acetyl‐L‐cysteine (NAC), and decitabine. Enrolled patients were randomly allocated to either Arm A (decitabine, day −12 to −10; NAC, day −9 to +30; mBUCY, day −9 to −2), or Arm B (mBUCY regimen followed by stem cells infusion). Seventy‐six patients in Arm A and 78 patients in Arm B were finally evaluated. The results showed platelet recovery accelerate in Arm A, with more patients achieving a platelet count of ≥50 × 109/L than Arm B at day +30 and +60 (p = .004 and .043, respectively). The cumulative incidence of relapse is 11.8% (95% CI 0.06–0.22) in Arm A, and 24.4% (95% CI 0.16–0.35) in Arm B (p = .048). The estimated 3‐year overall survival rate was 86.4% (±4.4%) and 79.9% (±4.7%) in 2 arms, respectively (p = .155). EFS at 3 years was 79.2% (±4.9%) in Arm A and 60.0% (±5.9%) in Arm B (p = .007). Intracellular reactive oxygen species (ROS) level was found to be reversely correlated with platelet recovery, and fewer patients in Arm A displayed excessive ROS within hematopoietic progenitor cells compared to Arm B. In conclusion, the addition of decitabine and NAC to mBUCY is a feasible and promising conditioning therapy for myeloid malignancies patients.
“…Hemorrhagic cystitis (HC) is a common complication following hematopoietic stem cell transplant (HCT) associated with viral infections and/or administration of high dose cyclophosphamide (CY) 1,2 . Preventative measures including hyperhydration and the acrolein‐neutralizing agent mesna are useful in preventing HC but do not prevent all cases 3 . Once HC occurs, the associated dysuria can be debilitating and difficult to treat 1 .…”
Section: Introductionmentioning
confidence: 99%
“…1,2 Preventative measures including hyperhydration and the acrolein-neutralizing agent mesna are useful in preventing HC but do not prevent all cases. 3 Once HC occurs, the associated dysuria can be debilitating and difficult to treat. 1 For this reason, multiple agents are used to treat severe dysuria.…”
Hemorrhagic cystitis is a common complication following the use of cyclophosphamide. Associated dysuria can be painful and there are few good options to relieve pain. Phenazopyridine has historically been utilized for dysuria and is available over the counter. However, it is associated with hematologic side effects with prolonged use. Here we present a case of a patient who developed Heinz body hemolysis following prolonged administration of phenazopyridine to treat cyclophosphamide‐induced hemorrhagic cystitis following hematopoietic stem cell transplant.
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