Selective embolization of the internal iliac arteries for the treatment of severe hemorrhagic cystitis following hematopoietic SCT

Han, Yue; Wu, Depei; Sun, Aining; Xie, Yandi; Xu, Jing; Zhou, Jun; Zhu, Xiaoli; Wang, Z; Ruan, Changgeng

doi:10.1038/bmt.2008.4

Cited by 37 publications

(36 citation statements)

References 45 publications

(64 reference statements)

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“…Treatments include hydration, forced diuresis, blood transfusion and antiviral treatment in CMV-positive patients. Six patients received selective embolization of the internal iliac arteries as salvage treatment, as previously described [10]. The cumulative incidence curve of remission is shown in figure 1.…”

Section: Resultsmentioning

confidence: 99%

“…Antiviral treatment with cidofovir may be a potentially effective therapy in this setting, especially for virus-associated patients, but its use still requires confirmation in randomized controlled trials [6]. Other treatments such as hyperbaric oxygen treatment, fibrin glue, activated recombinant factor VII as well as selective embolization of the internal iliac arteries and intravesical formalin are sometimes considered in severe and refractory LO-HC, but their application also remains limited due to controversial efficacy or complications secondary to therapy [3,7,8,9,10]. There is, therefore, a need to identify novel strategies.…”

Section: Introductionmentioning

confidence: 99%

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Mesenchymal Stromal Cells as an Adjuvant Treatment for Severe Late-Onset Hemorrhagic Cystitis after Allogeneic Hematopoietic Stem Cell Transplantation

Wang

Chen

et al. 2014

Acta Haematol

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The management of severe late-onset hemorrhagic cystitis (LO-HC) after allogeneic hematopoietic stem cell transplantation (HSCT) is still challenging. Because mesenchymal stromal cells (MSCs) possess anti-inflammatory and tissue repair-promoting properties, we retrospectively analyzed the efficacy and safety of MSC infusions in 7 of 33 patients with severe LO-HC after allogeneic HSCT. During treatment, each patient received at least one MSC infusion of Wharton's jelly derived from the umbilical cord of a third-party donor. In 6 patients, MSC treatment was initiated within 3 days of gross hematuria onset, while the 7th patient received an infusion 40 days later. The median dose was 1.0 (0.8-1.6) × 10⁶/kg. Five of 7 patients responded to treatment. Notably, gross hematuria promptly disappeared in 3 patients after 1 infusion, with a time to remission not seen in patients without MSC infusion. Two patients showed no response even after several infusions. No acute or late complications were recorded. Our findings indicate that MSC transfusion might be a feasible and safe supplemental therapy for patients with severe LO-HC after allogeneic HSCT.

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Section: Resultsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Mesenchymal Stromal Cells as an Adjuvant Treatment for Severe Late-Onset Hemorrhagic Cystitis after Allogeneic Hematopoietic Stem Cell Transplantation

Wang

Chen

et al. 2014

Acta Haematol

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“…Treatment for this difficult disease requires a wide range of invasiveness. For example, intravenous, endoscopic and instillation therapy (aluminium hydroxide, magnesium hydroxide aminocaproic acid, alum, silver nitrate solution) (2)(3)(4)(5), hyperbaric oxygen therapy and a vascular approach (selective embolization of the internal iliac arteries) may be possible conservative therapies (6,7). Total cystectomy may be a final option for patients with refractory HC (8).…”

Section: Introductionmentioning

confidence: 99%

Aplastic anemia associated with severe hemorrhagic cystitis following radiotherapy for prostate cancer

Nakano

Izumi

Maolake

et al. 2016

Molecular and Clinical Oncology

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Abstract. Hemorrhagic cystitis is a rare complication following radiotherapy for intrapelvic cancer types, including cervical cancer, bladder cancer and prostate cancer. The severity of hemorrhagic cystitis is different in each case, although symptoms improve spontaneously in certain cases, and often significant morbidity requiring numerous interventions occurs. Since no treatment strategy exists with high evidences for such severe hemorrhagic cystitis, urologists have difficulty in solving the bleeding and pain, which the patients suffer. Aplastic anemia is a rare blood disorder, with an incidence reported as 2/1 million individuals annually. Patients have a risk of diffuse bleeding for presentation with anemia, thrombocytopenia and neutropenia. The present report presented a case of severe hemorrhagic cystitis remitted successfully by the treatment for underlying aplastic anemia.

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“…5 In many patients, severe hematuria cannot be controlled by conservative measures such as irrigation of the bladder, instillation of formalin, silver nitrate, estrogen, epidermal growth factor, increase of intravesical hydrostatic pressure or hyperbaric oxygen therapy, or using endoscopic procedures with electrocoagulation, laser or argon hemostasis. [1][2][3][4]6 Cystectomy is not always an option since these patients often have a high surgical risk. 1,2,4 Arterial embolization is a safe, minimally invasive option that can be used to control hematuria caused by bladder hemorrhage.…”

Section: Introductionmentioning

confidence: 99%

“…[1][2][3] Causes of massive hematuria include carcinoma of the bladder, actinic cystitis, cystitis induced by cyclophosphamide, transurethral prostate resection, carcinoma of the prostate, 1,2,4 spontaneous, iatrogenic or traumatic arteriovesical fistula. 5 In many patients, severe hematuria cannot be controlled by conservative measures such as irrigation of the bladder, instillation of formalin, silver nitrate, estrogen, epidermal growth factor, increase of intravesical hydrostatic pressure or hyperbaric oxygen therapy, or using endoscopic procedures with electrocoagulation, laser or argon hemostasis.…”

Section: Introductionmentioning

confidence: 99%

Embolização vesical superseletiva para tratamento de hematúria maciça por cistite actínica

2015

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This article describes the case of a 46-year-old female patient who had been treated with radiotherapy for cervical cancer. She developed actinic cystitis with frequent episodes of severe hematuria. She required repeated catheterization to manage urinary retention, blood transfusions and hospital admissions. Conservative measures and attempts to achieve hemostasis by cystoscopy were unsuccessful at controlling bleeding. The patient therefore underwent endovascular treatment with superselective embolization of the vesical arteries and other vascular pedicles found to be linked with the bleeding. The procedure was successful and the patient has been in follow-up for 9 months with no need for further blood transfusions or admission to hospital. According to a review of the literature, use of this technique has not previously been described in Brazil.Keywords: therapeutic embolization; cystitis; hematuria; endovascular procedures; urinary bladder. ResumoOs autores relatam o caso de uma paciente de 46 anos de idade, que, após ter sido submetida a tratamento radioterápico por neoplasia de colo uterino, desenvolveu cistite actínica com episódios frequentes de hematúria franca. A paciente necessitou ser submetida a repetidos cateterismos vesicais por retenção urinária, hemotransfusões e internacões hospitalares. As medidas conservadoras e as tentativas de hemostasia por cistoscopia não foram bem-sucedidas no controle do sangramento. A paciente foi então submetida a tratamento endovascular com embolização superseletiva das artérias vesicais e outros pedículos vasculares, que se demonstraram associados ao sangramento. O procedimento foi bem-sucedido e a paciente vem sendo acompanhada há nove meses sem a necessidade de novas hemotransfusões nem de novas internações hospitalares. De acordo com a revisão da literatura, o uso dessa técnica ainda não havia sido descrito em trabalhos brasileiros.

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Selective embolization of the internal iliac arteries for the treatment of severe hemorrhagic cystitis following hematopoietic SCT

Cited by 37 publications

References 45 publications

Mesenchymal Stromal Cells as an Adjuvant Treatment for Severe Late-Onset Hemorrhagic Cystitis after Allogeneic Hematopoietic Stem Cell Transplantation

Mesenchymal Stromal Cells as an Adjuvant Treatment for Severe Late-Onset Hemorrhagic Cystitis after Allogeneic Hematopoietic Stem Cell Transplantation

Aplastic anemia associated with severe hemorrhagic cystitis following radiotherapy for prostate cancer

Embolização vesical superseletiva para tratamento de hematúria maciça por cistite actínica

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