Hemorrhagic cystitis following hematopoietic stem cell transplantation: incidence, risk factors and association with CMV reactivation and graft-versus-host disease / 中华医学杂志(英文版)
Chinese Medical Journal
;
(24): 1666-1671, 2007.
Artículo
en Inglés
| WPRIM
| ID: wpr-280365
ABSTRACT
<p><b>BACKGROUND</b>The definite pathogenesis of hemorrhagic cystitis (HC) after allogenic hematopoietic stem cell transplantation (allo-HSCT) has not been well elucidated. The role of cytomegalovirus (CMV) reactivation and graft-versus-host disease (GVHD) in the development of HC remains obscure. This study determined the incidence and risk factors for HC after allo-HSCT and analyzed its association with CMV reactivation and GVHD.</p><p><b>METHODS</b>We retrospectively studied 250 patients at high risk for CMV disease who underwent allo-HSCT all based on busulfan/cyclophosphamide (BU/CY) myloablative regimens. The incidence, etiology, risk factors and clinical management of HC were investigated.</p><p><b>RESULTS</b>HC developed within 180 days of transplant in 72 patients, with an overall incidence of 28.8% and an incidence of 12.6% in patients with HLA-matched related donors (MRD), 34.38% in those with HLA-matched unrelated donors (MUD), 49.45% in those with mismatched related donors (MMRD). CMV-viremia significantly increased the incidence of later onset HC (LOHC); however, only 9 out of 15 patients with CMV viruria actually developed LOHC. Multiple regression analysis identified grade II - IV acute GVHD (RR = 2.75; 95% CI 1.63 +/- 4.66; P < 0.01) and grafts from MUD or MMRD (RR = 2.60; 95% CI 1.52 +/- 5.20; P < 0.01) as independent risk factors for HC. Event sequence analysis indicated a majority of HC episodes began around GVHD initiation.</p><p><b>CONCLUSIONS</b>CMV-viremia is a high risk factor for LOHC. Our data also showed a correlation between acute GVHD and HC, which suggested that alloimmunity may be involved in the pathogenesis of HC.</p>
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Índice:
WPRIM (Pacífico Occidental)
Asunto principal:
Viremia
/
Activación Viral
/
Epidemiología
/
Incidencia
/
Análisis Multivariante
/
Estudios Retrospectivos
/
Factores de Riesgo
/
Infecciones por Citomegalovirus
/
Trasplante de Células Madre Hematopoyéticas
/
Cistitis
Tipo de estudio:
Estudio de etiología
/
Estudio de incidencia
/
Estudio observacional
/
Estudio pronóstico
/
Factores de riesgo
Límite:
Adulto
/
Anciano
/
Humanos
Idioma:
Inglés
Revista:
Chinese Medical Journal
Año:
2007
Tipo del documento:
Artículo
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