Incidence, clinical outcome, and management of virus-induced hemorrhagic cystitis in children and adolescents after allogeneic hematopoietic cell transplantation
| Autor: | Ewa Gorczyńska, Alicja Chybicka, Katarzyna Rybka, D. Turkiewicz, Agnieszka Dyla, Zofia Szczyra, Krzysztof Kałwak, Jacek Toporski |
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| Rok vydání: | 2005 |
| Předmět: |
Male
Transplantation Conditioning viruses JC virus medicine.disease_cause Gastroenterology chemistry.chemical_compound Risk Factors Cystitis Adenovirus Mass Screening Cumulative incidence Prospective Studies Child Children Incidence Hematopoietic Stem Cell Transplantation virus diseases Disease Management Hematology Allogeneic hematopoietic cell transplantation Total body irradiation JC Virus BK virus Treatment Outcome Child Preschool Viruses Female Polyomavirus Cidofovir Adult medicine.medical_specialty Adolescent Organophosphonates Hemorrhage Adenoviridae Cytosine Internal medicine Hemorrhagic cystitis medicine Humans Transplantation Homologous Mass screening Transplantation business.industry Infant medicine.disease chemistry Immunology DNA Viral business |
| Zdroj: | Biology of blood and marrow transplantation : journal of the American Society for Blood and Marrow Transplantation. 11(10) |
| ISSN: | 1083-8791 |
| Popis: | We analyzed the incidence, etiology, risk factors, and clinical management of hemorrhagic cystitis (HC) in 102 children who underwent allogeneic stem cell transplantation: 28 from matched siblings, 57 from unrelated donors, and 17 from mismatched relatives. Conditioning regimens consisted of high-dose chemotherapy (n = 83) or total body irradiation (n = 19). In all children, urine and plasma were prospectively screened for human polyomavirus (HPV; BK virus [BKV] and JC virus [JCV]) or adenovirus (AdV) DNA with a polymerase chain reaction–based assay. Viral DNA was detected in the urine of 56 children (54.9%): BKV in 48 (47%), JCV in 4 (3.9%), and AdV in 4 (3.9%). HC occurred in 26 children (25.5%), and viruria was detected in all of them: BKV in 21 (80.8%), AdV in 4 (14.4%), and JCV in 1 (3.8%). All patients with AdV viruria developed HC. The cumulative incidence of HC in patients with HPV viruria was 0.43. The only significant risk factor for HC in patients with HPV-positive urine was conditioning with high-dose chemotherapy. Twenty-two children were treated with cidofovir, with no significant toxicity. In all treated patients but 1, the clinical symptoms were moderate, and no HC-related death was observed. We conclude that virus-induced HC is a frequent complication after allogeneic hematopoietic cell transplantation. Treatment with cidofovir is feasible, and further studies are warranted to evaluate its activity in HC mediated by BKV or JCV. |
| Databáze: | OpenAIRE |
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