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Hemorrhagic Cystitis Requiring Bladder Irrigation is Associated with Poor Mortality in Hospitalized Stem Cell Transplant Patients
Raup, Valary T.; Potretzke, Aaron M.; Manley, Brandon J.; Brockman, John A.; Bhayani, Sam B..
Afiliação
  • Raup, Valary T.; Washington University. School of Medicine. Division of Urology. Washington. US
  • Potretzke, Aaron M.; Washington University. School of Medicine. Division of Urology. Washington. US
  • Manley, Brandon J.; Washington University. School of Medicine. Division of Urology. Washington. US
  • Brockman, John A.; Washington University. School of Medicine. Division of Urology. Washington. US
  • Bhayani, Sam B.; Washington University. School of Medicine. Division of Urology. Washington. US
Int. braz. j. urol ; 41(6): 1126-1131, Nov.-Dec. 2015. tab
Artigo em Inglês | LILACS | ID: lil-769771
Biblioteca responsável: BR1.1
ABSTRACT

Purpose:

To evaluate the overall prognosis of post-stem cell transplant inpatients who required continuous bladder irrigation (CBI) for hematuria. Materials and

Methods:

We performed a retrospective analysis of adult stem cell transplant recipients who received CBI for de novo hemorrhagic cystitis as inpatients on the bone marrow transplant service at Washington University from 2011-2013. Patients who had a history of genitourinary malignancy and/or recent surgical urologic intervention were excluded. Multiple variables were examined for association with death.

Results:

Thirty-three patients met our inclusion criteria, with a mean age of 48 years (23-65). Common malignancies included acute myelogenous leukemia (17/33, 57%), acute lymphocytic leukemia (3/33, 10%), and peripheral T cell lymphoma (3/33, 10%). Median time from stem cell transplant to need for CBI was 2.5 months (0 days-6.6 years). All patients had previously undergone chemotherapy (33/33, 100%) and 14 had undergone prior radiation therapy (14/33, 42%). Twenty-eight patients had an infectious disease (28/33, 85%), most commonly BK viremia (19/33, 58%), cytomegalovirus viremia (17/33, 51%), and bacterial urinary tract infection (8/33, 24%). Twenty-two patients expired during the same admission as CBI treatment (22/33 or 67% of total patients, 22/28 or 79% of deaths), with a 30-day mortality of 52% and a 90-day mortality of 73% from the start of CBI.

Conclusions:

Hemorrhagic cystitis requiring CBI is a symptom of severe systemic disease in stem cell transplant patients. The need for CBI administration may be a marker for mortality risk from a variety of systemic insults, rather than directly attributable to the hematuria.
Assuntos


Texto completo: Disponível Coleções: Bases de dados internacionais Base de dados: LILACS Assunto principal: Transplante de Células-Tronco Hematopoéticas / Cistite / Hematúria Tipo de estudo: Estudo de etiologia / Estudo de avaliação / Estudo observacional / Estudo prognóstico / Fatores de risco Limite: Adulto / Idoso / Feminino / Humanos / Masculino País/Região como assunto: América do Norte Idioma: Inglês Revista: Int. braz. j. urol Assunto da revista: Urologia Ano de publicação: 2015 Tipo de documento: Artigo País de afiliação: Estados Unidos Instituição/País de afiliação: Washington University/US

Texto completo: Disponível Coleções: Bases de dados internacionais Base de dados: LILACS Assunto principal: Transplante de Células-Tronco Hematopoéticas / Cistite / Hematúria Tipo de estudo: Estudo de etiologia / Estudo de avaliação / Estudo observacional / Estudo prognóstico / Fatores de risco Limite: Adulto / Idoso / Feminino / Humanos / Masculino País/Região como assunto: América do Norte Idioma: Inglês Revista: Int. braz. j. urol Assunto da revista: Urologia Ano de publicação: 2015 Tipo de documento: Artigo País de afiliação: Estados Unidos Instituição/País de afiliação: Washington University/US
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