BK VIRUS INFECTIONS IN PATIENTS WITH UNDERGOING ALLOGENEIC HEMATOPOIETIC STEM CELL TRANSPLANTATION
(Abstract release date: 05/19/16)
EHA Library. Antmen B. 06/09/16; 135084; PB2184
Prof. Bulent Antmen
Contributions
Contributions
Abstract
Abstract: PB2184
Type: Publication Only
Background
Hemorrhagic cystitis (HC) is a well-known complication following allogeneic hematopoietic stem cell transplantation (allo-HSCT) that can be categorized as early-onset or late-onset. Early-onset HC is usually caused by adenovirus or cytomegalovirus whereas late-onset HC mainly by polyomavirus BK. BU-containing myeloablative conditioning, unrelated donors and GVHD has been reported as risk factors increasing the chance of infection in bone marrow-transplant patients. Furthermore reactivation of human polyomavirus BK (BKV) may cause polyomavirusassociated nephropathy or polyoma virus-associated hemorrhagic cystitis.
Aims
We aimed to present 17 patients with BK polyoma virus (BKV) ascociated hemorrhagic cystitis and 2 patients with BK polyoma virus associated hemorrhagic cystitis and nephritis.
Methods
Between 2013 and 2015, 90 patients received an allogeneic BMT at Acibadem Adana Hospital Pediatric Bone Marrow Transplantation Unit. 17 patients experienced BKV associated hemorrhagic cystitis and nephritis. BKV was detected in the urine analysis and blood by PCR (polymerase chain reaction) in all patients.
Results
We presented 17 patients with BKV infection, age ranging from 3 to 20 with an average of 11.7 years. They underwent allo-HSCT due to thalassemia major (9 patients), aplastic anemia (3 patients) and leukemia (5 patients). The patients were treated with hydration, continuous bladder irrigation, ciprofloxacin, cidofovir and weekly intravesical hyaluronic acid instillation for four weeks. Ten patients showed complete resolution of hematuria. Three patients with refractory following therapy also received hyperbaric oxygen. Hemodialysis was performed in two patients who developed renal failure due to nephritis.
Conclusion
Past exposures with the BK virus is widespread but significant consequences of infection are uncommon in the immunocompetent population. Reactivation of infection occurs under conditions of immunosuppression such as during GVHD treatment with patients who underwent HSCT. Early detection and treatment is crucial for successful management of BKV cystitis and nephritis. Neverthless even when treated with all the modalities, in some patients treatment faillure can be observed.
Session topic: E-poster
Keyword(s): Bone marrow transplant, Childhood, Infection
Type: Publication Only
Background
Hemorrhagic cystitis (HC) is a well-known complication following allogeneic hematopoietic stem cell transplantation (allo-HSCT) that can be categorized as early-onset or late-onset. Early-onset HC is usually caused by adenovirus or cytomegalovirus whereas late-onset HC mainly by polyomavirus BK. BU-containing myeloablative conditioning, unrelated donors and GVHD has been reported as risk factors increasing the chance of infection in bone marrow-transplant patients. Furthermore reactivation of human polyomavirus BK (BKV) may cause polyomavirusassociated nephropathy or polyoma virus-associated hemorrhagic cystitis.
Aims
We aimed to present 17 patients with BK polyoma virus (BKV) ascociated hemorrhagic cystitis and 2 patients with BK polyoma virus associated hemorrhagic cystitis and nephritis.
Methods
Between 2013 and 2015, 90 patients received an allogeneic BMT at Acibadem Adana Hospital Pediatric Bone Marrow Transplantation Unit. 17 patients experienced BKV associated hemorrhagic cystitis and nephritis. BKV was detected in the urine analysis and blood by PCR (polymerase chain reaction) in all patients.
Results
We presented 17 patients with BKV infection, age ranging from 3 to 20 with an average of 11.7 years. They underwent allo-HSCT due to thalassemia major (9 patients), aplastic anemia (3 patients) and leukemia (5 patients). The patients were treated with hydration, continuous bladder irrigation, ciprofloxacin, cidofovir and weekly intravesical hyaluronic acid instillation for four weeks. Ten patients showed complete resolution of hematuria. Three patients with refractory following therapy also received hyperbaric oxygen. Hemodialysis was performed in two patients who developed renal failure due to nephritis.
Conclusion
Past exposures with the BK virus is widespread but significant consequences of infection are uncommon in the immunocompetent population. Reactivation of infection occurs under conditions of immunosuppression such as during GVHD treatment with patients who underwent HSCT. Early detection and treatment is crucial for successful management of BKV cystitis and nephritis. Neverthless even when treated with all the modalities, in some patients treatment faillure can be observed.
Session topic: E-poster
Keyword(s): Bone marrow transplant, Childhood, Infection
Abstract: PB2184
Type: Publication Only
Background
Hemorrhagic cystitis (HC) is a well-known complication following allogeneic hematopoietic stem cell transplantation (allo-HSCT) that can be categorized as early-onset or late-onset. Early-onset HC is usually caused by adenovirus or cytomegalovirus whereas late-onset HC mainly by polyomavirus BK. BU-containing myeloablative conditioning, unrelated donors and GVHD has been reported as risk factors increasing the chance of infection in bone marrow-transplant patients. Furthermore reactivation of human polyomavirus BK (BKV) may cause polyomavirusassociated nephropathy or polyoma virus-associated hemorrhagic cystitis.
Aims
We aimed to present 17 patients with BK polyoma virus (BKV) ascociated hemorrhagic cystitis and 2 patients with BK polyoma virus associated hemorrhagic cystitis and nephritis.
Methods
Between 2013 and 2015, 90 patients received an allogeneic BMT at Acibadem Adana Hospital Pediatric Bone Marrow Transplantation Unit. 17 patients experienced BKV associated hemorrhagic cystitis and nephritis. BKV was detected in the urine analysis and blood by PCR (polymerase chain reaction) in all patients.
Results
We presented 17 patients with BKV infection, age ranging from 3 to 20 with an average of 11.7 years. They underwent allo-HSCT due to thalassemia major (9 patients), aplastic anemia (3 patients) and leukemia (5 patients). The patients were treated with hydration, continuous bladder irrigation, ciprofloxacin, cidofovir and weekly intravesical hyaluronic acid instillation for four weeks. Ten patients showed complete resolution of hematuria. Three patients with refractory following therapy also received hyperbaric oxygen. Hemodialysis was performed in two patients who developed renal failure due to nephritis.
Conclusion
Past exposures with the BK virus is widespread but significant consequences of infection are uncommon in the immunocompetent population. Reactivation of infection occurs under conditions of immunosuppression such as during GVHD treatment with patients who underwent HSCT. Early detection and treatment is crucial for successful management of BKV cystitis and nephritis. Neverthless even when treated with all the modalities, in some patients treatment faillure can be observed.
Session topic: E-poster
Keyword(s): Bone marrow transplant, Childhood, Infection
Type: Publication Only
Background
Hemorrhagic cystitis (HC) is a well-known complication following allogeneic hematopoietic stem cell transplantation (allo-HSCT) that can be categorized as early-onset or late-onset. Early-onset HC is usually caused by adenovirus or cytomegalovirus whereas late-onset HC mainly by polyomavirus BK. BU-containing myeloablative conditioning, unrelated donors and GVHD has been reported as risk factors increasing the chance of infection in bone marrow-transplant patients. Furthermore reactivation of human polyomavirus BK (BKV) may cause polyomavirusassociated nephropathy or polyoma virus-associated hemorrhagic cystitis.
Aims
We aimed to present 17 patients with BK polyoma virus (BKV) ascociated hemorrhagic cystitis and 2 patients with BK polyoma virus associated hemorrhagic cystitis and nephritis.
Methods
Between 2013 and 2015, 90 patients received an allogeneic BMT at Acibadem Adana Hospital Pediatric Bone Marrow Transplantation Unit. 17 patients experienced BKV associated hemorrhagic cystitis and nephritis. BKV was detected in the urine analysis and blood by PCR (polymerase chain reaction) in all patients.
Results
We presented 17 patients with BKV infection, age ranging from 3 to 20 with an average of 11.7 years. They underwent allo-HSCT due to thalassemia major (9 patients), aplastic anemia (3 patients) and leukemia (5 patients). The patients were treated with hydration, continuous bladder irrigation, ciprofloxacin, cidofovir and weekly intravesical hyaluronic acid instillation for four weeks. Ten patients showed complete resolution of hematuria. Three patients with refractory following therapy also received hyperbaric oxygen. Hemodialysis was performed in two patients who developed renal failure due to nephritis.
Conclusion
Past exposures with the BK virus is widespread but significant consequences of infection are uncommon in the immunocompetent population. Reactivation of infection occurs under conditions of immunosuppression such as during GVHD treatment with patients who underwent HSCT. Early detection and treatment is crucial for successful management of BKV cystitis and nephritis. Neverthless even when treated with all the modalities, in some patients treatment faillure can be observed.
Session topic: E-poster
Keyword(s): Bone marrow transplant, Childhood, Infection
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