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Andreev et al. (Abstract)

Cellular Therapy and Transplantation (CTT), Vol. 3, No. 9
doi: 10.3205/ctt-2010-No9-abstract79
© The Authors. This abstract is provided under the following license: Creative Commons Attribution 3.0 Unported

Abstract accepted for "4th Raisa Gorbacheva Memorial Meeting on Hematopoietic Stem Cell Transplantation",
Saint Petersburg, Russia, September 18–20, 2010

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Hemorrhagic cystitis after allogeneic hematopoietic stem cell transplantation in children and adolescents

Sergey A. Andreev, Vladimir N. Vavilov, Oleg V. Goloschapov, Andrey V. Kozlov, Ludmila S. Zubarovskaya, Boris V. Afanasyev

R.M. Gorbacheva Memorial Institute of Children Hematology and Transplantation, Pavlov State Medical University, Saint-Petersburg, Russia

Correspondence: Vladimir N. Vavilov, R.M. Gorbacheva Memorial Institute of Children Hematology and Transplantation, Saint-Petersburg Pavlov State Medical University, 6/8, Tolstoy str., Saint-Petersburg, 197022, Russia, E-mail: vladimir_vavilov@spam is badmail.ru

Abstract

Background: Hemorrhagic cystitis (HC) is one of the most frequent (up to 25%) complications of allogeneic hematopoietic stem cell transplantation (HSCT), which increases inpatient period and can be the cause of death. The causes of HC are not only cytostatics (especially cyclophosphamide (CY)) toxicity, but also viral infections and, probably, graft-versus-host disease (GVHD).

Objective: We provide a survival analysis of patients that contracted HC after allogeneic HSCT.

Material and methods: Seventy-eight pediatric and adolescent patients (age 1–20 years) after allogeneic HSCT were included in the study. Most of them had had acute leukemia (70.51%; n=55), and other conditions included aplastic anemia 9 (11.54%), myelodisplastic syndromes 4 (5.13%), chronic myeloid leukemia 3 (3.85%), and 7 patients (8.97%) had other diagnoses. HSCT from related donors was provided to 52 patients (66.6%), and 26 patients (33.3%) received HSCT from unrelated donors,. Myeloablative conditioning with CY at a total dose of 120 mg/kg was used in 53.8% of patients (n=42).

Results: HC was observed in 13 (16.6%) patients (age 6–20 years). Most of them underwent CY-containing conditioning (69%). CMV-reactivation was observed in 61% (8 patients), and EBV-reactivation in 38.4% (5 patients). Eight patients (61%) had acute GVHD. Survival analysis shows the difference between overall survival (OS) in patients with and without HC (median OS 17 weeks vs. not achieved, p=0.06).

Conclusion: HC significantly influences survival after allogeneic HSCT. Most cases are caused not only by CY, but also by cytostatic agents and viral infection combinations and GVHD. This data calls for adequate diagnostics and treatment of the primary cause of HC.

Keywords: allogeneic HSCT, hemorrhagic cystitis, viral infections, GVHD

 

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