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. 2015 Nov;50(11):1432-7.
doi: 10.1038/bmt.2015.162. Epub 2015 Jul 13.

Hemorrhagic cystitis after allogeneic hematopoietic cell transplantation: risk factors, graft source and survival

L E Lunde  1 , S Dasaraju  1 , Q Cao  2 , C S Cohn  3 , M Reding  1 , N Bejanyan  1 , B Trottier  1 , J Rogosheske  1 , C Brunstein  1 , E Warlick  1 , J A H Young  4 , D J Weisdorf  1 , C Ustun  1
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Hemorrhagic cystitis after allogeneic hematopoietic cell transplantation: risk factors, graft source and survival

L E Lunde et al. Bone Marrow Transplant. 2015 Nov.

Abstract

Although hemorrhagic cystitis (HC) is a common complication of allogeneic hematopoietic cell transplantation (alloHCT), its risk factors and effects on survival are not well known. We evaluated HC in a large cohort (n=1321, 2003-2012) receiving alloHCT from all graft sources, including umbilical cord blood (UCB). We compared HC patients with non-HC (control) patients and examined clinical variables at HC onset and resolution. Of these 1321 patients, 219 (16.6%) developed HC at a median of 22 days after alloHCT. BK viruria was detected in 90% of 109 tested HC patients. Median duration of HC was 27 days. At the time of HC diagnosis, acute GVHD, fever, severe thrombocytopenia and steroid use were more frequent than at the time of HC resolution. In univariate analysis, male sex, age <20 years, myeloablative conditioning with cyclophosphamide and acute GVHD were associated with HC. In multivariate analysis, HC was significantly more common in males and HLA-mismatched UCB graft recipients. Severe grade HC (grade III-IV) was associated with increased treatment-related mortality but not with overall survival at 1 year. HC remains hazardous and therefore better prophylaxis, and early interventions to limit its severity are still needed.

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Conflict of interest statement

No Conflict of Interest to disclose

Figures

Figure 1
Figure 1
Overall survival patients with HC and control.
Figure 2
Figure 2
Treatment-related mortality among control patients, patients with grade I–II HC, and patients with grade III–IV HC.
See this image and copyright information in PMC

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