[The clinical effect of factor XIII on drug-induced hemorrhagic cystitis]

The therapeutic effects of Factor XIII (F XIII) concentrate against drug-induced hemorrhagic cystitis (HC) was investigated. HC occurred in 4 children with malignant disease during anti-cancer chemotherapy. Two (CML and T-ALL) of 4 patients developed HC after the administration of high dose cyclophosphamide as conditioning for allo bone marrow transplantation or peripheral blood stem cell autografts, and the other 2 patients (rhabdomyosarcoma, Wilm's tumor) developed HC after the administration of ifosfamide for relapse. When F XIII concentrate at a dose of 20 to 230 U/kg was administrated immediately after the onset of HC, the symptoms, i.e., bladder irritability and macrohematuria disappeared within a few days. The F XIII serum levels of those patients were low (27-57%), and the levels increased (63-230%) after administration of F XIII concentrate. The two patients with relapsed solid tumor showed no symptoms of HC during subsequent ifosfamide treatment when F XIII concentrate was administrated to maintain a normal F XIII range. These results suggest that the administration of F XIII concentrate may be useful for the prophylaxis and treatment of drug-induced HC in patients with a low F XIII level.