Severe hemorrhagic cystitis caused by the BK polyomavirus is associated with decreased survival post‐allogeneic hematopoietic stem cell transplantation

Kerbauy, Lucila Nassif; Kerbauy, Mariana Nassif; Bautzer, Vivien; Chapchap, Eduardo Cerello; Mattos, Vinicius R. P.; Rocha, J.D.; Esteves, Iracema; Kutner, José Mauro; Kerbauy, Fábio R.; Ribeiro, Andreza Alice Feitosa; Machado, Clarisse Martins; Hamerschlak, Nelson; Santos, Fábio Pires de Souza

doi:10.1111/tid.13101

Cited by 25 publications

(37 citation statements)

References 39 publications

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“…Lu et al [ 23 ] showed that the occurrence of HC during non- in vitro depletion of T cell haploids was significantly higher than that of homologous transplantation and believed that ATG was related to the occurrence of HC. Kerbauy et al [ 7 ] indicated that the use of ATG during pretreatment significantly increased the BKPyV infection-associated incidence of HC. A recent study by Mo et al [ 24 ] showed that the cumulative incidence of HC after haplo-HSCT in 149 cases of ATG-based MAC was 29.8% and the cumulative incidence of severe (Grades III–IV) HC was 10.9%.…”

Section: Discussionmentioning

confidence: 99%

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Effect of late-onset hemorrhagic cystitis on PFS after haplo-PBSCT

Chen

et al. 2021

Open Medicine

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Introduction This study is to investigate the effect of late-onset hemorrhagic cystitis (LOHC) on progression-free survival (PFS) of patients after haploidentical peripheral blood hematopoietic stem cell transplantation (haplo-PBSCT). Methods This retrospective study enrolled 74 patients with hematological malignancies treated with a myeloablative conditioning regimen and haplo-PBSCT. The effect of LOHC on PFS was studied in terms of HC occurrence, grade, disease type, duration, onset time, gender, and age. Results There were 28 patients with LOHC, and no case was with early-onset HC. The cumulative incidence of LOHC was 37.8% (95% CI: 26.9–48.7%). The 2-year expected PFS of 74 patients and 34 AML patients was not significantly different between LOHC patients and patients without HC (P > 0.05). Among 27 ALL patients, the 2-year expected PFS of LOHC patients was 75%, significantly higher than patients without HC (54.2%) (P < 0.05). The 2-year expected PFSs of patients with mild LOHC and severe LOHC were 69.8 and 77.8%, respectively (P > 0.05). Similarly, the onset time, duration, age, and gender of LOHC patients did not show significant effects on PFS (P > 0.05). Conclusions After haplo-PBSCT, LOHC has a significant effect on the PFS of ALL patients. The HC grade, duration, onset time, gender, and age have no significant effect on PFS.

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Section: Discussionmentioning

confidence: 99%

“…Kerbauy et al [ 7 ] reported that HC did not significantly affect long-term survival but severe HC would reduce the long-term survival after transplantation. However, it has been shown that BKV-associated HC is a main cause of morbidity after allo-HSCT and is associated with prolonged hospitalization [ 8 , 9 ].…”

Section: Introductionmentioning

confidence: 99%

Effect of late-onset hemorrhagic cystitis on PFS after haplo-PBSCT

Chen

et al. 2021

Open Medicine

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“…The urethra is more narrow in younger patients, which is closely associated with the CBI failure of HC. Lucila et al [9]. reviewed 133 recipients undergoing HSCT and found that younger patients were more likely to develop BK polyomavirus related HC in multivariate regression analysis and had a worse prognosis.…”

Section: Discussionmentioning

confidence: 99%

Impact of CRP on continuous bladder irrigation in hemorrhagic cystitis patients after hematopoietic stem cell transplantation

Yang

et al. 2020

Preprint

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Background Continuous bladder irrigation (CBI) and proper adjustment of saline irrigation speed are important to avoid CBI failure in hemorrhagic cystitis (HC) patients after allogeneic hematopoietic stem cell transplantation (HSCT). Nevertheless, too fast irrigation speed could take away the patient's much heat, contribute to blood coagulopathy, and increase the nursing workload. Evaluation of risk for CBI failure remains an unmet clinical need. Methods The general information, clinical characteristics, and consultation records of HC patients in 1380 patients with hematopoietic stem cell transplantation in our center from 2017 to 2019 were analyzed retrospectively. The receiver operating characteristic (ROC) curve was used to calculate the cutoff point of the continuous variable, and multivariate logistic regression was used to analyze the risk factors affecting CBI failure in HC patients. Results The incidence of HC after HSCT was 23%. A total of 227 patients with HC above grade 2 were included. Univariate analysis showed that CRP, age, platelet counts, onset time after transplantation, albumin, and hemoglobin were associated with CBI failure in the short-term (P < 0.05). ROC curve and multivariate logistic regression analysis showed that CRP > 8.89 ng/ml (RR = 7.828, 95% CI 2.885–21.244), age < 14.5 years (RR = 9.940, 95% CI 3.219–30.697), and onset time of HC༞37d after transplantation (RR = 7.021, 95% CI 2.204–22.364), were independent risk factors for failure of CBI (P < 0.05). Conclusions The study identified CRP > 8.89 ng/ml, age < 14.5 years, and onset time of HC after HSCT > 37d are independent factors for failure of CBI, which could be combined to allow stratification of HC after HSCT patients into low-, intermediate- and high-risk subgroups of CBI failure.

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“…The urethra is more narrow in younger patients, which is closely associated with the CBI failure of HC. Lucila et al [11]. reviewed 133 recipients undergoing HSCT and found that younger patients were more likely to develop BK polyomavirus related HC in multivariate regression analysis and had a worse prognosis.…”

Section: Discussionmentioning

confidence: 99%

Multivariate analysis of factors for failed continuous bladder irrigation in hemorrhagic cystitis patients after hematopoietic stem cell transplantation

Yang

et al. 2020

Preprint

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Background: Continuous bladder irrigation (CBI) and proper adjustment of saline irrigation speed are important to avoid CBI failure in hemorrhagic cystitis (HC) patients after allogeneic hematopoietic stem cell transplantation (HSCT). Nevertheless, too fast irrigation speed could take away the patient's much heat, contribute to blood coagulopathy, and increase the nursing workload. Evaluation of risk for CBI failure remains an unmet clinical need.Methods: The general information, clinical characteristics, and consultation records of HC patients in 1380 patients with hematopoietic stem cell transplantation in our center from 2017 to 2019 were analyzed retrospectively. The receiver operating characteristic (ROC) curve was used to calculate the cutoff point of the continuous variable, and multivariate logistic regression was used to analyze the risk factors affecting CBI failure in HC patients.Results: The incidence of HC after HSCT was 23%. A total of 227 patients with HC above grade 2 were included. Univariate analysis showed that CRP, age, platelet counts, onset time after transplantation, albumin, and hemoglobin were associated with CBI failure in the short-term (P < 0.05). ROC curve and multivariate logistic regression analysis showed that CRP > 8.89 ng/ml (RR = 7.828, 95% CI 2.885-21.244), age < 14.5 years (RR = 9.940, 95% CI 3.219-30.697), and onset time of HC＞37d after transplantation (RR = 7.021, 95% CI 2.204-22.364), were independent risk factors for failure of CBI (P < 0.05).Conclusions: The study identified CRP > 8.89 ng/ml, age < 14.5 years, and onset time of HC after HSCT > 37d are independent factors for failure of CBI, which could be combined to allow stratification of HC after HSCT patients into low-, intermediate- and high-risk subgroups of CBI failure.

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Severe hemorrhagic cystitis caused by the BK polyomavirus is associated with decreased survival post‐allogeneic hematopoietic stem cell transplantation

Cited by 25 publications

References 39 publications

Effect of late-onset hemorrhagic cystitis on PFS after haplo-PBSCT

Effect of late-onset hemorrhagic cystitis on PFS after haplo-PBSCT

Impact of CRP on continuous bladder irrigation in hemorrhagic cystitis patients after hematopoietic stem cell transplantation

Multivariate analysis of factors for failed continuous bladder irrigation in hemorrhagic cystitis patients after hematopoietic stem cell transplantation

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