Endovesical instillation of Cidofovir in the treatment of BK polyomavirus hemorrhagic cystitis after allogeneic hematopoietic cell transplantation.

Autor: Voisot A; Department of Clinical Hematology, University Hospital of Liège, CHU Sart-Tilman, 4000 Liège, Belgium., Triffaux F; Department of Urology, University Hospital of Liège, CHU Sart-Tilman, 4000 Liège, Belgium., Roland I; Department of Pharmacy, University Hospital of Liège, CHU Sart-Tilman, 4000 Liège, Belgium., Meex C; Laboratory of Microbiology, University Hospital of Liège, CHU Sart-Tilman, 4000 Liège, Belgium., Detrembleur N; Department of Pathology, University Hospital of Liège, CHU Sart-Tilman, 4000 Liège, Belgium., Baron F; Department of Clinical Hematology, University Hospital of Liège, CHU Sart-Tilman, 4000 Liège, Belgium; Hematology Research Unit GIGA-I3, University of Liège, CHU Sart-Tilman, 4000 Liège, Belgium., Willems E; Department of Clinical Hematology, University Hospital of Liège, CHU Sart-Tilman, 4000 Liège, Belgium., David W; Department of Urology, University Hospital of Liège, CHU Sart-Tilman, 4000 Liège, Belgium., Beguin Y; Department of Clinical Hematology, University Hospital of Liège, CHU Sart-Tilman, 4000 Liège, Belgium; Hematology Research Unit GIGA-I3, University of Liège, CHU Sart-Tilman, 4000 Liège, Belgium., Servais S; Department of Clinical Hematology, University Hospital of Liège, CHU Sart-Tilman, 4000 Liège, Belgium; Hematology Research Unit GIGA-I3, University of Liège, CHU Sart-Tilman, 4000 Liège, Belgium. Electronic address: s.servais@chuliege.be.
Jazyk: angličtina
Zdroj: Current research in translational medicine [Curr Res Transl Med] 2023 Jan-Mar; Vol. 71 (1), pp. 103366. Date of Electronic Publication: 2022 Sep 22.
DOI: 10.1016/j.retram.2022.103366
Abstrakt: Background: Hemorrhagic cystitis (HC) with BK polyomavirus (BKPyV) is a common complication after allogeneic hematopoietic cell transplantation (alloHCT) that may lead to severe discomfort for the patient and significant morbidity (urinary obstruction, increased transfusion requirements and prolonged hospitalization). So far, there is no clear consensus on how to manage this complication.
Patients and Methods: Here, we report a single-center case series of 9 patients (4 children and 5 adults) treated with cidofovir endovesical (EV) instillation(s) for BKPyV-HC after alloHCT. EV Cidofovir was administered at a dose of 5 mg/kg, for 1 to 3 instillations (with a minimum delay between 2 successive doses of 5 days).
Results: Eight out of the 9 treated patients with EV Cidofovir achieved a complete resolution of HC after 1-3 instillation(s), without recurrence of symptomatic infection within the next 3 months. Only 1 adult patient did not improve after treatment and developed severe morbidity (emphysematous cystitis).
Conclusion: Although this single-center case series of EV cidofovir for BKPyV HC after alloHCT shows encouraging results, only large prospective studies will definitively establish the effectiveness of this therapy.
Competing Interests: Declaration of Competing Interest None
(Copyright © 2022 Elsevier Masson SAS. All rights reserved.)
Databáze: MEDLINE
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