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Recombinant factor VIIa to treat late radiation-induced hemorrhagic cystitis: a case report
John P Geisler1, Georgiann C Linnemeier, Kelly J Manahan
1Division of Gynecologic Oncology, St. Vincent Hospitals, Indianapolis, Indiana, USA. jgeisler@indianawomensoncology.com
Background:
Late radiation cystitis is one of the most difficult complications of radiation therapy for pelvic malignancies.
Case:
A 29-year-old woman with a history of cervical cancer presented with radiation-induced hemorrhagic cystitis. The patient received multiple units of packed red blood cells while undergoing several intravesical treatments, including continuous bladder irrigation, 4% formalin, 0.15% AgNO3 and Mg(OH)2 with Al(OH)3. The bleeding finally was stopped by the use of intravenous recombinant factor VIIa.
Conclusion:
When hemorrhagic cystitis related to late radiation complications is refractory to conventional management, intravenous recombinant factor VIIa may be of benefit.
