A Ruggeri1,2, G Roth-Guepin1,3, G Battipaglia1,4, A-C Mamez1, F Malard1,2, A Gomez1, E Brissot1,2,5, R Belhocine1, A Vekhoff1, S Lapusan1, F Isnard1, O Legrand1, J Gozlan6, D Boutolleau7, T Ledraa1, M Labopin1,5, M-T Rubio1,2, M Mohty1,2,5. 1. Service d'Hématologie et Thérapie Cellulaire, Hôpital Saint Antoine, AP-HP, Paris, France. 2. INSERM, UMRs 938, Paris, France. 3. Service d'Hématologie, CHU Nancy, Nancy, France. 4. Ematologia, Università Federico II di Napoli, Naples, Italy. 5. Université Pierre & Marie Curie, Paris, France. 6. Service de Virologie, Hôpital Saint Antoine, AP-HP, Paris, France. 7. Service de Virologie, Hôpitaux Universitaires Pitié-Salpêtrière, AP-HP, Paris, France.
Abstract
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.
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.
Authors: A Rimondo; R Crocchiolo; J El-Cheikh; S Bramanti; A Granata; S Furst; B Sarina; L Morabito; R Devillier; S Harbi; B Mohty; R Mineri; C Faucher; C Chabannon; A Santoro; D Blaise; L Castagna Journal: Bone Marrow Transplant Date: 2016-07-18 Impact factor: 5.483
Authors: Heather J Symons; Marianna Zahurak; Yilin Cao; Allen Chen; Kenneth Cooke; Christopher Gamper; Orly Klein; Nicolas Llosa; Elias T Zambidis; Richard Ambinder; Javier Bolaños-Meade; Ivan Borrello; Robert Brodsky; Amy DeZern; Ivana Gojo; Margaret Showel; Lode Swinnen; B Douglas Smith; Leo Luznik; Richard J Jones; Ephraim J Fuchs Journal: Blood Adv Date: 2020-08-25