Journal
ANNALS OF HEMATOLOGY
Volume 97, Issue 7, Pages 1209-1217Publisher
SPRINGER
DOI: 10.1007/s00277-018-3290-0
Keywords
Allogeneic hematopoietic stem cell transplantation; Late-onset hemorrhagic cystitis; Corticosteroid; Virus
Categories
Funding
- Beijing Talents fund [2015000021223ZK39]
- National Natural Science Foundation of China [81530046]
- Foundation for Innovative Research Groups of the National Natural Science Foundation of China [81621001]
- Science and Technology Project of Guangdong Province of China [2016B030230003]
- Foundation for Nursing Research of the Peking University Health Science Center [BMU20160515]
Ask authors/readers for more resources
We aimed to evaluate the treatments, particularly the role of corticosteroids, in patients with late-onset hemorrhagic cystitis (LOHC) after allogeneic hematopoietic stem cell transplantation (allo-HSCT). One hundred and sixty-three consecutive patients who underwent non-T-cell-depleted allo-HSCT and met the criterion of LOHC after allo-HSCT were enrolled in this study. The median time from allo-HSCT to the occurrence of LOHC was 29 (range, 4-155) days. Pathogens identified in blood and/or urine samples from 143 patients were mostly viruses. All of the patients with LOHC received intravenous fluid hydration, alkalization, and forced diuresis, of which 2 patients achieved complete remission (CR) after these treatments. The remaining 161 patients received anti-infection therapies and 71 achieved CR after the therapies. Corticosteroids were additionally applied to 83 out of 90 patients who did not achieve CR after anti-infection therapies, and 88.0% (n = 73) of them showed a grade 3 to 4 LOHC at the beginning of corticosteroid therapy. Thirty-five patients showed an immediate response (CR or downgraded at least one grade) within 1 week after the beginning of the corticosteroid therapy. Sixty-four patients (77.1%) achieved CR after corticosteroid therapy, and the median period from the beginning of corticosteroid therapy to CR was 17 days. Thus, we observed that viruses were the most common pathogens in LOHC after allo-HSCT and that anti-infection therapies were critical. For patients not showing a satisfactory response to anti-infection therapies, additional corticosteroid therapy may help to achieve CR.
Authors
I am an author on this paper
Click your name to claim this paper and add it to your profile.
Reviews
Recommended
No Data Available