Premium
An Unexpected Surge in Plasma BKP yV Viral Load Heralds the Development of BKP yV‐Associated Metastatic Bladder Cancer in a Lung Transplant Recipient With BKP yV Nephropathy
Author(s) -
Kuppachi S.,
Holanda D.,
Eberlein M.,
Alexiev B.,
Tyler A. J.,
Wissel M. C.,
Kleiboeker S. B.,
Thomas C. P.
Publication year - 2017
Publication title -
american journal of transplantation
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.89
H-Index - 188
eISSN - 1600-6143
pISSN - 1600-6135
DOI - 10.1111/ajt.14057
Subject(s) - medicine , viral load , covid-19 , bladder cancer , oncology , nephropathy , virology , cancer , immunology , virus , infectious disease (medical specialty) , disease , diabetes mellitus , endocrinology , outbreak
We report a lung transplant recipient who developed BK polyoma virus ( BKPyV ) DNA emia and BKPyV nephropathy. With careful management of his immunosuppression he achieved significant reduction in BKPyV DNA emia and stabilization of his kidney function. He later developed a high‐grade bladder cancer and shortly thereafter he experienced a major upsurge in the level of BKPyV DNA emia that coincided with the discovery of hepatic metastasis. Retrospectively, the bladder cancer and the hepatic secondary tumor stained uniformly for SV 40 large T antigen, and the BKPyV DNA sequences identified in plasma corresponded to BKPyV DNA within hepatic tissue, indicating that the spike in BKPyV load was likely derived from the circulating tumor cells or cell‐free tumor DNA following metastases of a BKV ‐associated cancer. To the best of our knowledge, this is the first description of a surge in BKPyV load in a patient with controlled BKP y VN that heralded the appearance of a metastatic urothelial malignancy. This report discusses the literature on BKPyV ‐associated malignancies and the possibility that unexplained increases in BKPyV DNA emia may be a biomarker for metastatic BKPyV ‐related urothelial cancer.