Viral-induced Hemorrhagic Cystitis After Allogeneic Hematopoietic Stem Cell Transplant

Dosin, G.; Aoun, Fouad; Rassy, Elie El; Assi, Tarek; Lewalle, Philippe; Blanc, Jeremy; Velthoven, Roland Van; Bron, Dominique

doi:10.1016/j.clml.2017.05.013

Cited by 16 publications

(10 citation statements)

References 19 publications

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“…Despite the ability to decrease incidence through sufficient hydration and the use of mesna [ 24 ], conditioning-induced early-onset HC is still a problem and occurred in 7% of our patients. We found increased risk for HC with myeloablative conditioning and the presence of acute GVHD in univariate analysis, and the use of Cy and the occurrence of CMV and BKV in multivariate analysis, similar to prior reports [ 16 , 24 , 25 , 26 ].…”

Section: Discussionsupporting

confidence: 90%

Prospective Analysis of Hemorrhagic Cystitis and BK Viremia in Allogeneic Hematopoietic Stem Cell Transplantation

Atilla

Ateş

Uslu

et al. 2019

Tjh

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Objective: BK virus (BKV) infection has been shown to be related to hemorrhagic cystitis (HC) in allogeneic hematopoietic stem cell transplantation (allo-HSCT). There are conflicting data regarding the association between BKV titers in plasma and clinical disease as well as the risk factors for BKV-related HC. Our aim is to study the risk factors and relationship with plasma BK viral load for development of HC in a prospective analysis. Materials and Methods: We prospectively evaluated 59 patients who received allo-HSCT between 2014 and 2016 by quantitative BK virus polymerase chain reaction (PCR) (Altona Diagnostics, Germany) from blood samples at days 0, 30, 60, and 90 after allo-HSCT. The patients were monitored for signs and symptoms of HC. Results: HC was diagnosed in 22 patients (37%) at a mean of 100 days (range: 0-367 days). In multivariate analysis, the usage of cyclophosphamide (sub-distribution hazard ratio [sdHR]: 7.82, confidence interval [CI]: 1.375-39.645, p=0.02), reactivated CMV (sdHR: 6.105, CI: 1.614-23.094, p=0.008), and positive BKV viremia (sdHR: 2.15, CI: 1.456-22.065, p=0.01) significantly increased the risk of developing HC. Patients with higher viral loads at day 30 and day 60 were diagnosed with more severe HC (p<0.001). Median BK viral loads of >101.5 copies/mL at day 0 (sensitivity 0.727, specificity 0.875), >98.5 copies/mL at day 30 (sensitivity 0.909, specificity 0.875), and >90.0 copies/mL at day 60 (sensitivity 0.909, specificity 0.875) were indicative of HC. Conclusion: Our study showed that administration of cyclophosphamide, CMV reactivation, and BK virus positivity were associated with HC. Plasma BK virus PCR titers at days 0, 30, and 60 after transplant were sensitive tools for predicting clinically proven HC.

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Section: Discussionsupporting

confidence: 90%

Prospective Analysis of Hemorrhagic Cystitis and BK Viremia in Allogeneic Hematopoietic Stem Cell Transplantation

Atilla

Ateş

Uslu

et al. 2019

Tjh

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“…In this study, the HC incidence (27%) was similar to other studies, although reported ranges are wide 3 , 6 , 22 , 31 In our outpatient HSCT program, hydration could be not efficiently delivered during the conditioning regimen and post-transplantation cyclophosphamide administration, favoring HC in our patients. To minimize the risk, we used Mesna and hydration, from commencement until six hours after the end of the cyclophosphamide infusion.…”

Section: Discussionsupporting

confidence: 83%

Outpatient haploidentical hematopoietic stem cell transplant using post-transplant cyclophosphamide and incidence of hemorrhagic cystitis

Gutiérrez-Aguirre

Esparza-Sandoval

Palomares-Leal

et al. 2022

Hematology, Transfusion and Cell Therapy

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“…The cases of 73 patients who underwent allogeneic HSCT at our hospital between January 2010 and June 2012 were reviewed. Patients who died ≤21 days after undergoing HSCT were excluded from the analysis because the median time of onset of BKV‐HC is ≥21 days after HSCT 11–13 . Cases in which a second HSCT was performed because of primary graft failure were also excluded.…”

Section: Methodsmentioning

confidence: 99%

A cluster of BK polyomavirus‐associated hemorrhagic cystitis after allogeneic hematopoietic stem cell transplantation

Hosoi

Murata

Suzuki

et al. 2021

Transplant Infectious Dis

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Background BK polyomavirus (BKV) can cause hemorrhagic cystitis (HC) in immunocompromised patients after hematopoietic stem cell transplantation (HSCT). It remains unclear whether nosocomial BKV infections occur. During a 9‐month period, an increase in BKV‐associated HC (BKV‐HC) cases was observed at our institution. Aim The BKV‐HC cluster population was compared with populations of HSCT patients from before and after the BKV‐HC cluster to evaluate whether nosocomial BKV transmission had occurred. Methods A retrospective analysis was carried out to assess the risk of patients developing BKV‐HC after HSCT. The background data of the cluster patients were compared with those of the patients who underwent HSCT before or after the cluster, and the collected BKV isolates were serotyped. Results BKV‐HC involving grade ≥2 hematuria occurred in six of 15 HSCT recipients during a 9‐month period. The incidence of BKV‐HC was significantly higher in this period than in the other periods (p = 0.0014). There were no significant differences in the patients’ background data between the cluster and non‐cluster periods, including in terms of risk factors for BKV‐HC. Serotype analyses of BKV revealed that the BKV detected in the urine samples from four of the six BKV‐HC patients belonged to subtype Ic. The gene sequences of these four BKV exhibited >99.5% homology. Conclusion Our study suggests that nosocomial BKV infections may occur after HSCT. Although many cases of BKV‐HC are caused by the reactivation of a latent virus, it is necessary to employ appropriate hygiene measures when cases of BKV‐HC occur.

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Viral-induced Hemorrhagic Cystitis After Allogeneic Hematopoietic Stem Cell Transplant

Cited by 16 publications

References 19 publications

Prospective Analysis of Hemorrhagic Cystitis and BK Viremia in Allogeneic Hematopoietic Stem Cell Transplantation

Prospective Analysis of Hemorrhagic Cystitis and BK Viremia in Allogeneic Hematopoietic Stem Cell Transplantation

Outpatient haploidentical hematopoietic stem cell transplant using post-transplant cyclophosphamide and incidence of hemorrhagic cystitis

A cluster of BK polyomavirus‐associated hemorrhagic cystitis after allogeneic hematopoietic stem cell transplantation

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