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Factor XIII replacement in stem-cell transplant recipients with severe hemorrhagic cystitis: a report of four cases
Karine Demesmay1, Edgar Tissot, Claude-Eric Bulabois
1Department of Pharmacy, Besançon University Hospital, Boulevard Fleming, 25030 Besançon Cedex, France.
Background:
Hemorrhagic cystitis (HC) is an important cause of morbidity in patients undergoing allogeneic stem-cell transplantation (SCT). Various causes have been identified, such as the use of high-dose cyclophosphamide or busulfan and the occurrence of acute graft-versus-host disease or viral infections (cytomegalovirus, adenovirus, polyomavirus).
Methods:
The clinical course of four patients treated with factor XIII (FXIII) concentrate for severe HC after allogeneic SCT is described.
Results:
Four patients were treated with one or two infusions of 50 IU/kg of FXIII concentrate. Only one patient showed a plasmatic FXIII decrease before treatment. Three of the four patients responded to this treatment, and HC completely resolved in two of them. No adverse event was observed.
Conclusion:
The use of FXIII concentrate can improve the major symptoms of HC in patients with decreased or normal FXIII plasma level after allogeneic SCT.
