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- Title
Prospective analysis of BKV hemorrhagic cystitis in children and adolescents undergoing hematopoietic cell transplantation.
- Authors
Salamonowicz-Bodzioch, Małgorzata; Frączkiewicz, Jowita; Czyżewski, Krzysztof; Zając-Spychała, Olga; Gorczyńska, Ewa; Panasiuk, Anna; Ussowicz, Marek; Kałwak, Krzysztof; Szmit, Zofia; Wróbel, Grażyna; Kazanowska, Bernarda; Chybicka, Alicja; Ukielska-Hoffmann, Bogna; Wendycz-Domalewska, Danuta; Wysocki, Mariusz; Dziedzic, Magdalena; Wachowiak, Jacek; Zaucha-Prażmo, Agnieszka; Kowalczyk, Jerzy; Goździk, Jolanta
- Abstract
BK virus is one of the most common causes of hemorrhagic cystitis (HC) in children undergoing hematopoietic cell transplantation (HCT). Viruses can be found in urine and serum samples of immunocompromised patients. Malignant diseases, age, cell source, day of granulocyte reconstitution, conditioning regimen, or use of total body irradiation may play an important role in BKV epidemiology, development of hemorrhagic cystitis course, and outcome. The aim of this study was to evaluate the incidence, clinical course, and risk factors for BKV-HC in children undergoing HCT. A total number of 133 patients who were prospectively tested for BKV colonization/infection were enrolled into this multicenter analysis. Episodes of BKV-HC occurred in 36/133 (27%) enrolled subjects. In a univariate analysis for BKV-HC incidence, the following factors were significant: age >5 years, peripheral blood transplantation, matched unrelated donor (MUD) transplantation, busulfan-cyclophosphamide-melphalan conditioning regimen, and acute myeloblastic leukemia (AML) diagnosis. Presence of acute graft-versus-host disease (aGVHD) in liver and gut GVHD was a significant risk factor of BKV-HC. No BKV-attributed deaths were reported. In multivariate analysis, the incidence of HC was significantly higher in patients with AML, age >5 years, MUD transplants, and children with GVHD. HC is a frequent complication after HCT among children causes prolonged hospitalization but rarely contributes to death. We identified risk factors of BKV-HC development in children, with focus on aGVHD: we concluded that excessive immune reaction connected with GVHD and immunosuppression drugs might play a pivotal role in the development of BKV-HC.
- Subjects
HEMATOPOIETIC stem cell transplantation; TOTAL body irradiation; BK virus; ACUTE myeloid leukemia; CYSTITIS; DIAGNOSIS; GRAFT versus host disease; TUMOR treatment; ACUTE myeloid leukemia treatment; POLYOMAVIRUS diseases; VIRUSES; HOMOGRAFTS; DISEASE incidence; TUMORS; LONGITUDINAL method; DISEASE complications
- Publication
Annals of Hematology, 2021, Vol 100, Issue 5, p1283
- ISSN
0939-5555
- Publication type
journal article
- DOI
10.1007/s00277-021-04454-7