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学科主题: 临床医学
题名:
Hemorrhagic cystitis following hematopoietic stem cell transplantation: incidence, risk factors and association with CMV reactivation and graft-versus-host disease
作者: Xu Lan-ping; Zhang Hong-yu; Huang Xiao-jun; Liu Kai-yan; Liu Dai-hong; Han Wei; Chen Huan; Chen Yu-hong; Gao Zhi-yong; Zhang Yao-chen; Dao-pei, Lu
关键词: hemorrhagic cystitis ; allogeneic hematopoietic stem cell transplantation ; cytomegalovirus ; graft-versus-host disease
刊名: CHINESE MEDICAL JOURNAL
发表日期: 2007-10-05
卷: 120, 期:19, 页:1666-1671
收录类别: SCI
文章类型: Article
WOS标题词: Science & Technology
类目[WOS]: Medicine, General & Internal
研究领域[WOS]: General & Internal Medicine
关键词[WOS]: BONE-MARROW-TRANSPLANTATION ; BK VIRUS ; CYCLOPHOSPHAMIDE ; MANIFESTATION
英文摘要:

Background 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.

Methods 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.

Results 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% Cl 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.

Conclusions 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.

语种: 英语
WOS记录号: WOS:000250539700004
Citation statistics:
内容类型: 期刊论文
URI标识: http://ir.bjmu.edu.cn/handle/400002259/61770
Appears in Collections:北京大学第二临床医学院_血液科_期刊论文

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作者单位: Peking Univ, Inst Hematol, Peoples Hosp, Beijing 100044, Peoples R China

Recommended Citation:
Xu Lan-ping,Zhang Hong-yu,Huang Xiao-jun,et al. Hemorrhagic cystitis following hematopoietic stem cell transplantation: incidence, risk factors and association with CMV reactivation and graft-versus-host disease[J]. CHINESE MEDICAL JOURNAL,2007,120(19):1666-1671.
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