Is BK Virus-Associated Cystitis a Generalized Epithelial Disease?

Area of Science:

• Virology
• Oncology
• Immunology

Background:

• BK polyomavirus-associated haemorrhagic cystitis (BKHC) is a known complication following allogeneic stem cell transplantation (SCT), with incidence rates ranging from 5-60%.
• BK viruria, the presence of BK polyomavirus in urine, can occur in up to 100% of SCT cases and may precede or occur independently of BKHC.
• Limited data exists on the clinical course and associations of BKHC and BK viruria in adult SCT recipients.

Purpose of the Study:

• To prospectively investigate the incidence and clinical course of BK polyomavirus-associated haemorrhagic cystitis (BKHC) and BK viruria.
• To identify potential associations between BK viruria and clinical factors in adult patients undergoing their first allogeneic stem cell transplantation.

Main Methods:

• A prospective, unicentric, non-interventional trial was conducted.
• Forty adult patients (mean age 52.8 years) undergoing first allogeneic SCT were enrolled between November 2013 and December 2015.
• Patients were followed for 1 year post-inpatient treatment, monitoring for BKHC and BK viruria.

Main Results:

• Only one patient (2.5%) developed BKHC during inpatient treatment.
• BK viruria was frequent, observed in 27.5% during inpatient treatment and 35% during the 1-year follow-up.
• BK viruria showed a significant association with mucositis (p=0.038) and the number of transfused platelet concentrates (p=0.001).

Conclusions:

• BKHC appears to be infrequent in the early post-transplant period in this cohort.
• BK viruria is common after allogeneic SCT and may be linked to other transplant complications.
• The association between BK viruria, mucositis, and platelet transfusions warrants further investigation.