Literature DB >> 31321678

Intravesical application of platelet-rich plasma in patients with persistent haemorrhagic cystitis after hematopoietic stem cell transplantation: a single-centre preliminary experience.

Lorenzo Masieri1, Francesco Sessa2, Andrea Mari1, Riccardo Campi1, Gianmartin Cito1, Pierangelo Verrienti1, Chiara Nozzoli3, Riccardo Saccardi3, Simone Sforza1, Fabrizio Di Maida1, Antonio Andrea Grosso1, Marco Carini1, Andrea Minervini1.   

Abstract

PURPOSE: Haemorrhagic cystitis (HC) after allogeneic transplantation (HSCT) is a condition characterized by diffuse inflammation and bleeding from the bladder mucosa. Treatment of HC is not standardized and clinical Guidelines are elusive. The aim of this study was to evaluate the safety and efficacy of intravesical treatment with platelet-rich plasma (PRP) in patients with HC after allogenic HSCT.
METHODS: Data from ten consecutive patients with BK virus-induced HC between 2013 and 2017 were collected. HC was classified into four grades. Inclusion criteria were (a) grade 3 or 4 BKV-induced HC after allogenic HSCT; (b) HC refractory to conservative therapy. All patients underwent transurethral cystoscopy and PRP treatment under general anaesthesia.
RESULTS: Mean patients' age was 33.6 years. Four patients (40%) presented a grade 3 BKV-induced HC and six patients (60%) a grade 4. No intraoperative complications occurred. Postoperative complications were recorded in six patients: three patients required blood transfusion while three patients endovenous antibiotic therapy. Median time to catheter removal was 6 days (IQR 2-10). Median length of hospitalization was 35 days (IQR 6-73). At 30 days after surgery, a three-way catheter was repositioned in one patient for grade 4 haematuria, six patients had a complete response, and three a partial response.
CONCLUSIONS: Our preliminary experience suggests that intravesical administration of PRP should be considered as a feasible and safe option for the treatment of BK-induced HC after HSCT. Future studies are needed to assess its potential value in other forms of haemorrhagic cystitis.

Entities:  

Keywords:  Allogeneic hematopoietic transplantation; Bladder irrigation; Haematuria; Hemorrhagic cystitis; Platelet-rich plasma

Mesh:

Year:  2019        PMID: 31321678     DOI: 10.1007/s11255-019-02223-0

Source DB:  PubMed          Journal:  Int Urol Nephrol        ISSN: 0301-1623            Impact factor:   2.370


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