Successful treatment with intravesical cidofovir for virus-associated hemorrhagic cystitis after allogeneic hematopoietic stem cell transplantation: A case report and a review of the literature

Sakurada, Maki; Kondo, Tadakazu; Umeda, Mikio; Kawabata, Hiroshi; Yamashita, Kouhei; Takaori−Kondo, A.

doi:10.1016/j.jiac.2016.01.013

Cited by 23 publications

(16 citation statements)

References 25 publications

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“…Adenovirus cystitis has been reported to occur in a greater frequency especially amongst allogeneic transplant recipients and in patients with high grade GVHD and in those with severe immunosuppression [80, 81]. Management is supportive care but some case reports have proven that intravesical cidofivir therapy is superior to intravenous therapy against adenovirus cystitis; however, the data is very limited for now [82, 83]. …”

Section: Pathophysiology Of Acute Kidney Injury In Hsctmentioning

confidence: 99%

Acute Kidney Injury in Hematopoietic Stem Cell Transplantation: A Review

Krishnappa

Gupta

Manu

et al. 2016

International Journal of Nephrology

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Hematopoietic stem cell transplantation (HSCT) is a highly effective treatment strategy for lymphoproliferative disorders and bone marrow failure states including aplastic anemia and thalassemia. However, its use has been limited by the increased treatment related complications, including acute kidney injury (AKI) with an incidence ranging from 20% to 73%. AKI after HSCT has been associated with an increased risk of mortality. The incidence of AKI reported in recipients of myeloablative allogeneic transplant is considerably higher in comparison to other subclasses mainly due to use of cyclosporine and development of graft-versus-host disease (GVHD) in allogeneic groups. Acute GVHD is by itself a major independent risk factor for the development of AKI in HSCT recipients. The other major risk factors are sepsis, nephrotoxic medications (amphotericin B, acyclovir, aminoglycosides, and cyclosporine), hepatic sinusoidal obstruction syndrome (SOS), thrombotic microangiopathy (TMA), marrow infusion toxicity, and tumor lysis syndrome. The mainstay of management of AKI in these patients is avoidance of risk factors contributing to AKI, including use of reduced intensity-conditioning regimen, close monitoring of nephrotoxic medications, and use of alternative antifungals for prophylaxis against infection. Also, early identification and effective management of sepsis, tumor lysis syndrome, marrow infusion toxicity, and hepatic SOS help in reducing the incidence of AKI in HSCT recipients.

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Section: Pathophysiology Of Acute Kidney Injury In Hsctmentioning

confidence: 99%

Acute Kidney Injury in Hematopoietic Stem Cell Transplantation: A Review

Krishnappa

Gupta

Manu

et al. 2016

International Journal of Nephrology

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“…For patients in whom ADV and BKV were detected in serum, systemic cidofovir injection was initiated at 1 mg/kg, 3 three times a weekly. Meanwhile, for those in whom BKV and ADV were detected only in the urine, bladder instillation of cidofovir was preferred at 5 mg/kg for 2 consecutive days was preferred [13][14][15].…”

Section: Acv Bkv and Jcv Infectionsmentioning

confidence: 99%

Lymphocyte Area Under the Curve as a Predictive Factor for Viral Infection after Allogenic Hematopoietic Stem Cell Transplantation

Watanabe

Kanda

Hishizawa

et al. 2019

Biology of Blood and Marrow Transplantation

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Viral infection is a serious complication that can greatly affect patient mortality and morbidity after allogenic hematopoietic stem cell transplantation (allo-HSCT). For the early identification of patients at high risk for viral infection, we evaluated the impact of lymphocyte area under the curve (AUC) value as a new predictive factor for early immune reconstitution after allo-HSCT against viral infection. This study included 286 patients who underwent their first allo-HSCT at Kyoto University Hospital between 2005 and 2017. Lymphocyte AUC from day 0 to day +15 was calculated in the analysis of human herpesvirus 6 (HHV-6), and lymphocyte AUC from day 0 to day +30 was calculated in the analysis of other viruses (cytomegalovirus [CMV], adenovirus, BK virus, JC virus, and varicella zoster virus). The risk factors for each viral reactivation/infection were assessed by multivariate analysis. The median age at transplantation was 51 years (range, 17 to 68 years). The median lymphocyte AUC was 63/mL (range, 0 to 5620/mL) at day +15 and 3880 (range, 0 to 118,260/mL) at day +30. An increase in lymphocyte AUC was significantly associated with a high frequency of HHV-6 reactivation (P = .033) and a low frequency of CMV antigenemia (P = .014). No apparent association was found between lymphocyte AUC and reactivation/infection of other viruses. Aplastic anemia as a primary disease (hazard ratio [HR], 5.34; P < .001) and cord blood as a donor source (HR, 3.05; P = .006) were other risk factors for HHV-6 reactivation. Other risk factors for CMV antigenemia included the occurrence of acute graft-versus-host disease (HR 2.21; P < .001) and recipient age (HR 1.55; P = .017). Higher lymphocyte AUC at day +30 was significantly associated with low treatment-related mortality (HR, .47; P = .045). Lymphocyte AUC may be a good predictive factor for immune reconstitution against CMV reactivation. It also provides valuable information for predicting HHV-6 reactivation and treatment-related mortality.

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“…Consensus on general treatment strategies for HC is limited to supportive and symptomatic measures aimed to control and mitigate the effects of bleeding, the prevention of clot formation or renal obstruction. These measures often include hyperhydration, diuresis, continuous bladder irrigation, analgesia, and blood transfusions [7,24,26,[36][37][38]. Analgesia can range from treatment with topical agents, such as phenazopyridine, to systemic opioid therapy, such as morphine.…”

Section: Prevention and General Treatment Strategiesmentioning

confidence: 99%

Pharmacological Options for Viral Induced Hemorrhagic Cystitis Management: A Review of the Literature

Giles¹,

Wilder²,

Ritter³

et al. 2019

JPT

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Background: Viral induced hemorrhagic cystitis (VIHC) is very common among patients who become immunocompromised following organ transplantation. However, there is neither consensus on the standard of care nor clear guidelines to aid in clinical decision making when treatment VIHC. This review discusses currently available pharmacologic agents, presents investigational drug therapies, and outlines alternative treatment options that could be effective against VIHC.Recent findings: Letermovir is a novel antiviral agent approved for CMV prophylaxis in patients post-hematopoietic stem cell transplantation (HSCT). Although no studies have yet been conducted in patients with VIHC, this new antiviral agent shows promise in preventing emergence of CMV in patients after HSCT. Additionally, newer studies addressing the efficacy of brincidofovir, an experimental drug derived from cidofovir, against CMV infection may provide preliminary evidence for brincidofovir’s role in therapy and therefore warrant further investigation.Conclusion: Polyoma BK virus (BKV), cytomegalovirus (CMV), and adenovirus (ADV) are the primary culprits for HC occurrence in patients undergoing renal transplantation or allogeneic HSCT. CMV-associated HC could be prevented or treated by ganciclovir and valganciclovir because these agents’ effectiveness has been clearly established in other non-HC infections related to CMV. ADV-associated HC could be mitigated by brincidofovir and ribavirin, however the high toxicity associated with these agents may be a limiting factor for their use. BKV-associated HC is best managed by cidofovir and leflunomide, but not by fluoroquinolones. Finally, intravesicular instillation should be preferred in patients who experience toxicities associated with systemic use of antivirals.

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Successful treatment with intravesical cidofovir for virus-associated hemorrhagic cystitis after allogeneic hematopoietic stem cell transplantation: A case report and a review of the literature

Cited by 23 publications

References 25 publications

Acute Kidney Injury in Hematopoietic Stem Cell Transplantation: A Review

Acute Kidney Injury in Hematopoietic Stem Cell Transplantation: A Review

Lymphocyte Area Under the Curve as a Predictive Factor for Viral Infection after Allogenic Hematopoietic Stem Cell Transplantation

Pharmacological Options for Viral Induced Hemorrhagic Cystitis Management: A Review of the Literature

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