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Hemorrhagic cystitis as a complication of bone marrow transplantation
1Ankara University, Faculty of Medicine, Department of Hematology-Oncology, Ankara, Turkey.
Insights
Hemorrhagic cystitis (HC) is a common complication after bone marrow transplantation (BMT). This study found HC occurred in 34.3% of patients, often mild and transient, but sometimes severe and long-lasting.
Area of Science:
- Hematology
- Oncology
- Transplantation Medicine
Background:
- Hemorrhagic cystitis (HC) is a significant complication following bone marrow transplantation (BMT).
- The incidence and severity of HC vary based on transplant type and timing post-transplant.
- HC can be life-threatening, necessitating a thorough understanding of its occurrence.
Purpose of the Study:
- To investigate the incidence, timing, and characteristics of hemorrhagic cystitis (HC) in patients undergoing bone marrow transplantation (BMT).
- To identify potential risk factors and clinical patterns associated with HC development post-BMT.
Main Methods:
- Retrospective analysis of 134 patients (89 allogeneic, 45 autologous) who underwent BMT between May 1988 and August 1995.
- Data collected included HC incidence, onset, duration, severity, and correlation with patient demographics and treatment variables.
- Electron microscopy was used in select cases of late-onset HC.
Main Results:
- HC occurred in 34.3% of patients (38% allogeneic, 27% autologous).
- Onset ranged from 7 to 125 days post-transplant; 78.2% were early and transient, while 21.7% were late and persistent.
- No correlation found between HC incidence and age, sex, diagnosis, or mesna prophylaxis dosage. Severe HC was observed only in allogeneic transplants.
Conclusions:
- Hemorrhagic cystitis is a frequent complication of BMT, predominantly presenting as an early, transient condition.
- While often mild, severe and persistent HC can occur, particularly after allogeneic transplantation.
- Further investigation, including viral etiology in persistent cases, is warranted.
Abstract:
Hemorrhagic cystitis (HC) is one of the most troublesome complications of bone marrow transplantation (BMT) and sometimes may be life-threatening. The etiology and prevalence of HC depends on the type of the transplant and the period after BMT. Here we report about 134 patients transplanted in a single center (89 allogeneic and 45 autologous) between May 1988 and August 1995. Forty-six patients (34.3%) had HC after BMT. Thirty-four (38%) alloBMT patients and 12 (27%) autoBMT patients had HC (p = 0.18). The onset of HC was 7 to 125 days after transplantation. The degree of HC was mild to moderate in 25 (28%) and severe in 9 (10%) allogeneic transplants. In autologous transplants, all of the episodes of HC were mild to moderate. Age, sex, diagnosis and the dosage of mesna used for prophylaxis were not correlated with the incidence of HC. In 36 of 46 (78.2%) patients HC occurred early and as a transient form. Ten (21.7%) were late and long-lasting. In 2 patients who had late starting and long-lasting HC after allogeneic BMT, electron microscopic examinations revealed virus-like structures in bladder epithelial cells.