BK Virus-Related Haemorrhagic Cystitis in Non-Transplanted Children With Leukaemia

Area of Science:

• Pediatric Oncology
• Infectious Diseases
• Virology

Background:

• BK virus (BKV)-related hemorrhagic cystitis (HC) is a known complication in transplant recipients.
• HC is an unexpected complication in children with leukemia receiving standard chemotherapy.

Purpose of the Study:

• To investigate the occurrence and characteristics of BKV-related HC in non-transplanted children with leukemia.
• To identify potential risk factors and clinical features associated with BKV-related HC in this population.

Main Methods:

• Retrospective observational study of children with acute lymphoblastic leukemia (ALL) or acute myeloid leukemia (AML).
• Evaluation of disease status, HC grade, urinary BKV viral load, blood counts, imaging, treatments, and preceding conditions like oral mucositis and PRES.
• Urine BKV polymerase chain reaction (PCR) was used to detect BKV in patients presenting with hematuria.

Main Results:

• BKV was detected in 14 out of 23 (60.9%) children with leukemia.
• The majority of affected patients were older than 10 years and male, often in the consolidation phase of therapy and in remission.
• HC grades correlated with the neutrophil-to-lymphocyte ratio, and preceding oral mucositis or PRES were noted in a significant proportion of patients.

Conclusions:

• BKV-related HC is a potential complication in children with leukemia during the consolidation phase of treatment.
• Risk factors for BKV-related HC in pediatric leukemia patients resemble those observed in hematopoietic stem cell transplantation recipients.