Incidence and risk factors for hemorrhagic cystitis in unmanipulated haploidentical transplant recipients

Autor:	A.-C. Mamez, Françoise Isnard, T. Ledraa, Alejandro Palomar Gómez, Ollivier Legrand, M.-T. Rubio, Ramdane Belhocine, Annalisa Ruggeri, Mohamad Mohty, M. Labopin, J. Gozlan, Giorgia Battipaglia, Gabrielle Roth-Guepin, D. Boutolleau, Anne Vekhoff, Eolia Brissot, Florent Malard, Simona Lapusan
Přispěvatelé:	Ruggeri, A., Roth-Guepin, G., Battipaglia, G., Mamez, A. -C., Malard, F., Gomez, A., Brissot, E., Belhocine, R., Vekhoff, A., Lapusan, S., Isnard, F., Legrand, O., Gozlan, J., Boutolleau, D., Ledraa, T., Labopin, M., Rubio, M. -T., Mohty, M.
Rok vydání:	2015
Předmět:	Adult medicine.medical_specialty Cyclophosphamide Adolescent Cystiti Graft vs Host Disease Hemorrhage medicine.disease_cause Gastroenterology Immunosuppressive Agent Young Adult Immune system Risk Factors Internal medicine Cystitis Haplotype Medicine Humans Cumulative incidence Hemorrhagic cystiti Aged Transplantation business.industry Incidence (epidemiology) Risk Factor Incidence BK viru Hematopoietic Stem Cell Transplantation Middle Aged medicine.disease BK virus Surgery surgical procedures operative Infectious Diseases Haplotypes business Complication Post-transplant cyclophosphamide Immunosuppressive Agents Hemorrhagic cystitis medicine.drug Unmanipulated haploidentical transplant Human
Zdroj:	Transplant infectious disease : an official journal of the Transplantation Society. 17(6)
ISSN:	1399-3062
Popis:	Background Hemorrhagic cystitis (HC) is a common complication after hematopoietic allogeneic stem cell transplantation (HSCT) associated with intensity of the conditioning regimen, cyclophosphamide (Cy) therapy, and BK polyomavirus (BKPyV) infection. Methods We analyzed 33 consecutive haploidentical (haplo) HSCT recipients transplanted for hematologic diseases. Eleven patients had a previous transplant. Median follow-up was 11 months. Graft-versus-host disease (GVHD) prophylaxis consisted of cyclosporine + mycophenolate mofetil and post-HSCT Cy. Results Thirty-two of 33 patients achieved neutrophil recovery. Cumulative incidence (CI) of platelet recovery was 65%. CI grade II–IV acute GVHD was 44%. Twenty patients developed HC in a median time of 38 days. CI of HC at day 180 was 62%. BKPyV was positive in blood and urine of 91% of patients at HC onset. HC resolved in 18/20 patients. Factors associated with HC were previous transplant (P = 0.01) and occurrence of cytomegalovirus reactivation before HC (P = 0.05). Grade II–IV acute GVHD was not associated with HC (P = 0.62). CI of day 180 viral infections was 73%. Two-year overall survival (OS) was 50%; HC did not impact OS (P = 0.29). Conclusion The incidence of HC after haplo with post-HSCT Cy is high and is associated with morbidity, especially in high-risk patients such as those with a previous transplant history and with impaired immune reconstitution.
Databáze:	OpenAIRE
Externí odkaz:	https://explore.openaire.eu/search/publication?articleId=doi_dedup___::217aa04caec467dd9c7aed122b4ecf0f https://pubmed.ncbi.nlm.nih.gov/26354178 Zobrazit plný text záznamu Plný text ve formátu PDF Plný text ve formátu HTML
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