Kampo patterns and radiology in children receiving choreito for hemorrhagic cystitis after hematopoietic stem cell transplantation

Aim Choreito reduces the disease burden of hemorrhagic cystitis ( HC ) in children undergoing hematopoietic stem cell transplantation, but the underlying K ampo mechanism has not yet been clarified. To obtain pathophysiological insights, the present study evaluated changes in K ampo patterns and genitourinary imaging during choreito treatment. Methods Ten consecutive children with late‐onset HC after stem cell transplantation were treated with choreito. Kampo patterns and computed tomography ( CT ) before and after choreito treatment were retrospectively analyzed. Results Ten children with a median age of 9.7 years (range, 5.4–14 years) were diagnosed with late‐onset HC ; 9 had BK virus and 1 had adenovirus. The median duration from the beginning of choreito intake to complete resolution was 12 days (range, 4–28 days). All 10 children fulfilled the K ampo pattern of B ladder damp–heat at diagnosis; all had heat and/or hardness in the lower abdomen, and 8 children had a slippery pulse. CT was obtained in 4 of the 10 children at the time of diagnosis, all of which showed bladder wall thickening and perivesical inflammation. After choreito treatment for a median of 26 days (range, 8–40 days), none of the children had any sign of damp–heat, which coincided with the disappearance of perivesical inflammation, as confirmed on CT . Conclusion Lower abdominal heat/hardness with a slippery pulse may reflect damp–heat accumulation in the lower energizer, causing HC . Improvement in these examinations can be used as a surrogate response marker in choreito treatment for HC , which should be confirmed in future prospective studies.