Hemorrhagic cystitis after allogeneic hematopoietic cell transplantation: Risk factors, graft source and survival

L. E. Lunde, S. Dasaraju, Q. Cao, C. S. Cohn, M. Reding, N. Bejanyan, B. Trottier, J. Rogosheske, C. Brunstein, E. Warlick, J. A.H. Young, D. J. Weisdorf, C. Ustun

Research output: Contribution to journalArticlepeer-review

49 Scopus citations

Abstract

Although hemorrhagic cystitis (HC) is a common complication of allogeneic hematopoietic cell transplantation (alloHCT), its risk factors and effects on survival are not well known. We evaluated HC in a large cohort (n=1321, 2003-2012) receiving alloHCT from all graft sources, including umbilical cord blood (UCB). We compared HC patients with non-HC (control) patients and examined clinical variables at HC onset and resolution. Of these 1321 patients, 219 (16.6%) developed HC at a median of 22 days after alloHCT. BK viruria was detected in 90% of 109 tested HC patients. Median duration of HC was 27 days. At the time of HC diagnosis, acute GVHD, fever, severe thrombocytopenia and steroid use were more frequent than at the time of HC resolution. In univariate analysis, male sex, age <20 years, myeloablative conditioning with cyclophosphamide and acute GVHD were associated with HC. In multivariate analysis, HC was significantly more common in males and HLA-mismatched UCB graft recipients. Severe grade HC (grade III-IV) was associated with increased treatment-related mortality but not with overall survival at 1 year. HC remains hazardous and therefore better prophylaxis, and early interventions to limit its severity are still needed.

Original languageEnglish (US)
Pages (from-to)1432-1437
Number of pages6
JournalBone marrow transplantation
Volume50
Issue number11
DOIs
StatePublished - Nov 1 2015

Bibliographical note

Funding Information:
Qing Cao is supported by a grant from the National Cancer Institute CA065493-20.

Publisher Copyright:
© 2015 Macmillan Publishers Limited. All rights reserved.

Copyright:
Copyright 2016 Elsevier B.V., All rights reserved.

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