HEMOCOAGULASE FOR THE TREATMENT OF SEVERE HEMORRHAGIC CYSTITIS FOLLOWING HEMATOPOIETIC STEM CELL TRANSPLANTATION
(Abstract release date: 05/19/16)
EHA Library. Xue M. 06/09/16; 133082; E1533
Prof. Dr. Mengxing Xue
Contributions
Contributions
Abstract
Abstract: E1533
Type: Eposter Presentation
Background
Hemorrhagic cystitis (HC) is a common and potentially severe complication after allogeneic hematopoietic stem cell transplantation (HSCT). Despite many therapies have been tested in the treatment of severe HC, no definitive treatment has been established. Hemocoagulase is an established hemostatic agent, but its efficacy for HC has not been evaluated.
Aims
The aim of this study is to investigate the clinical efficacy of hemocoagulase for severe HC following HSCT.
Methods
We treated Twenty patients with severe HC (macroscopic hematuria with clots and macroscopic hematuria with renal or bladder dysfunction, with symptoms of cystitis) following HSCT with hemocoagulase. All the patients were initially treated with hyperhydration, forced diuresis and red cell and platelet transfusion support. For the patients with cytomegalovirus (CMV) replication in plasma determined by polymerase chain reaction, ganciclovir or foscarnet sodium was given. When patients developed macroscopic hematuria with clots, hemocoagulase was given, 1U iv twice per day for 5 days as a course. If the macroscopic hematuria disappeared at the sixth day after stopping the drug, hemocoagulase was no longer given. If not, the next course was given. During the treatment, the blood clotting factors was monitored for 2 to 3 times weekly. If the fibrinogen was decreased, the plasma or fibrinogen was transfused to correct the blood coagulation abnormality. The urine speciments reserved before and after hemocoagulase respectively were examined by naked eye and microscope to evaluate the efficacy.
Results
Patients included 12 males and 8 females with a median age of 27 years (range, 13–57years). The median time to onset of severe HC was 28 days after HSCT (range, 14 to 70 days). The HC was cured (disappearance of macroscopic hematuria without relapse) in 18 patients(2 cases were cured after 1 courses, 9 cases were cured after 2 courses, 2 cases were cured after 3 courses, 2 cases were cured after 4 courses, 2 cases were cured after 5 courses, 1 cases were cured after 9 courses), improved (amelioration of macroscopic hematuria) in 1 patients after 3 courses and uncontrolled (persistence of macroscopic hematuria with red cell transfusion requirements) in 1 patients who died of pulmonary infection and pneumorrhagia. For the patients with response, macroscopic hematuria disappeared at a median time of 28 days after the treatments (range, 4–127 days). Among 20 patients, 7 cases had no decrease of fibrinogen (2 cases were cured after 1 courses, 5 cases were cured after 2 courses), the other 13 cases had obvious decrease of fibrinogen, while after the infusion of plasma or fibrinogen, the fibrinogen recoveried. There was no patient required interruption of treatment.
Conclusion
Hemocoagulase seems to be a safe and effective drug for severe HC following HSCT.
Session topic: E-poster
Keyword(s): Hematopoietic cell transplantation, Hemorrhagic cystitis
Type: Eposter Presentation
Background
Hemorrhagic cystitis (HC) is a common and potentially severe complication after allogeneic hematopoietic stem cell transplantation (HSCT). Despite many therapies have been tested in the treatment of severe HC, no definitive treatment has been established. Hemocoagulase is an established hemostatic agent, but its efficacy for HC has not been evaluated.
Aims
The aim of this study is to investigate the clinical efficacy of hemocoagulase for severe HC following HSCT.
Methods
We treated Twenty patients with severe HC (macroscopic hematuria with clots and macroscopic hematuria with renal or bladder dysfunction, with symptoms of cystitis) following HSCT with hemocoagulase. All the patients were initially treated with hyperhydration, forced diuresis and red cell and platelet transfusion support. For the patients with cytomegalovirus (CMV) replication in plasma determined by polymerase chain reaction, ganciclovir or foscarnet sodium was given. When patients developed macroscopic hematuria with clots, hemocoagulase was given, 1U iv twice per day for 5 days as a course. If the macroscopic hematuria disappeared at the sixth day after stopping the drug, hemocoagulase was no longer given. If not, the next course was given. During the treatment, the blood clotting factors was monitored for 2 to 3 times weekly. If the fibrinogen was decreased, the plasma or fibrinogen was transfused to correct the blood coagulation abnormality. The urine speciments reserved before and after hemocoagulase respectively were examined by naked eye and microscope to evaluate the efficacy.
Results
Patients included 12 males and 8 females with a median age of 27 years (range, 13–57years). The median time to onset of severe HC was 28 days after HSCT (range, 14 to 70 days). The HC was cured (disappearance of macroscopic hematuria without relapse) in 18 patients(2 cases were cured after 1 courses, 9 cases were cured after 2 courses, 2 cases were cured after 3 courses, 2 cases were cured after 4 courses, 2 cases were cured after 5 courses, 1 cases were cured after 9 courses), improved (amelioration of macroscopic hematuria) in 1 patients after 3 courses and uncontrolled (persistence of macroscopic hematuria with red cell transfusion requirements) in 1 patients who died of pulmonary infection and pneumorrhagia. For the patients with response, macroscopic hematuria disappeared at a median time of 28 days after the treatments (range, 4–127 days). Among 20 patients, 7 cases had no decrease of fibrinogen (2 cases were cured after 1 courses, 5 cases were cured after 2 courses), the other 13 cases had obvious decrease of fibrinogen, while after the infusion of plasma or fibrinogen, the fibrinogen recoveried. There was no patient required interruption of treatment.
Conclusion
Hemocoagulase seems to be a safe and effective drug for severe HC following HSCT.
Session topic: E-poster
Keyword(s): Hematopoietic cell transplantation, Hemorrhagic cystitis
Abstract: E1533
Type: Eposter Presentation
Background
Hemorrhagic cystitis (HC) is a common and potentially severe complication after allogeneic hematopoietic stem cell transplantation (HSCT). Despite many therapies have been tested in the treatment of severe HC, no definitive treatment has been established. Hemocoagulase is an established hemostatic agent, but its efficacy for HC has not been evaluated.
Aims
The aim of this study is to investigate the clinical efficacy of hemocoagulase for severe HC following HSCT.
Methods
We treated Twenty patients with severe HC (macroscopic hematuria with clots and macroscopic hematuria with renal or bladder dysfunction, with symptoms of cystitis) following HSCT with hemocoagulase. All the patients were initially treated with hyperhydration, forced diuresis and red cell and platelet transfusion support. For the patients with cytomegalovirus (CMV) replication in plasma determined by polymerase chain reaction, ganciclovir or foscarnet sodium was given. When patients developed macroscopic hematuria with clots, hemocoagulase was given, 1U iv twice per day for 5 days as a course. If the macroscopic hematuria disappeared at the sixth day after stopping the drug, hemocoagulase was no longer given. If not, the next course was given. During the treatment, the blood clotting factors was monitored for 2 to 3 times weekly. If the fibrinogen was decreased, the plasma or fibrinogen was transfused to correct the blood coagulation abnormality. The urine speciments reserved before and after hemocoagulase respectively were examined by naked eye and microscope to evaluate the efficacy.
Results
Patients included 12 males and 8 females with a median age of 27 years (range, 13–57years). The median time to onset of severe HC was 28 days after HSCT (range, 14 to 70 days). The HC was cured (disappearance of macroscopic hematuria without relapse) in 18 patients(2 cases were cured after 1 courses, 9 cases were cured after 2 courses, 2 cases were cured after 3 courses, 2 cases were cured after 4 courses, 2 cases were cured after 5 courses, 1 cases were cured after 9 courses), improved (amelioration of macroscopic hematuria) in 1 patients after 3 courses and uncontrolled (persistence of macroscopic hematuria with red cell transfusion requirements) in 1 patients who died of pulmonary infection and pneumorrhagia. For the patients with response, macroscopic hematuria disappeared at a median time of 28 days after the treatments (range, 4–127 days). Among 20 patients, 7 cases had no decrease of fibrinogen (2 cases were cured after 1 courses, 5 cases were cured after 2 courses), the other 13 cases had obvious decrease of fibrinogen, while after the infusion of plasma or fibrinogen, the fibrinogen recoveried. There was no patient required interruption of treatment.
Conclusion
Hemocoagulase seems to be a safe and effective drug for severe HC following HSCT.
Session topic: E-poster
Keyword(s): Hematopoietic cell transplantation, Hemorrhagic cystitis
Type: Eposter Presentation
Background
Hemorrhagic cystitis (HC) is a common and potentially severe complication after allogeneic hematopoietic stem cell transplantation (HSCT). Despite many therapies have been tested in the treatment of severe HC, no definitive treatment has been established. Hemocoagulase is an established hemostatic agent, but its efficacy for HC has not been evaluated.
Aims
The aim of this study is to investigate the clinical efficacy of hemocoagulase for severe HC following HSCT.
Methods
We treated Twenty patients with severe HC (macroscopic hematuria with clots and macroscopic hematuria with renal or bladder dysfunction, with symptoms of cystitis) following HSCT with hemocoagulase. All the patients were initially treated with hyperhydration, forced diuresis and red cell and platelet transfusion support. For the patients with cytomegalovirus (CMV) replication in plasma determined by polymerase chain reaction, ganciclovir or foscarnet sodium was given. When patients developed macroscopic hematuria with clots, hemocoagulase was given, 1U iv twice per day for 5 days as a course. If the macroscopic hematuria disappeared at the sixth day after stopping the drug, hemocoagulase was no longer given. If not, the next course was given. During the treatment, the blood clotting factors was monitored for 2 to 3 times weekly. If the fibrinogen was decreased, the plasma or fibrinogen was transfused to correct the blood coagulation abnormality. The urine speciments reserved before and after hemocoagulase respectively were examined by naked eye and microscope to evaluate the efficacy.
Results
Patients included 12 males and 8 females with a median age of 27 years (range, 13–57years). The median time to onset of severe HC was 28 days after HSCT (range, 14 to 70 days). The HC was cured (disappearance of macroscopic hematuria without relapse) in 18 patients(2 cases were cured after 1 courses, 9 cases were cured after 2 courses, 2 cases were cured after 3 courses, 2 cases were cured after 4 courses, 2 cases were cured after 5 courses, 1 cases were cured after 9 courses), improved (amelioration of macroscopic hematuria) in 1 patients after 3 courses and uncontrolled (persistence of macroscopic hematuria with red cell transfusion requirements) in 1 patients who died of pulmonary infection and pneumorrhagia. For the patients with response, macroscopic hematuria disappeared at a median time of 28 days after the treatments (range, 4–127 days). Among 20 patients, 7 cases had no decrease of fibrinogen (2 cases were cured after 1 courses, 5 cases were cured after 2 courses), the other 13 cases had obvious decrease of fibrinogen, while after the infusion of plasma or fibrinogen, the fibrinogen recoveried. There was no patient required interruption of treatment.
Conclusion
Hemocoagulase seems to be a safe and effective drug for severe HC following HSCT.
Session topic: E-poster
Keyword(s): Hematopoietic cell transplantation, Hemorrhagic cystitis
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