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High incidence of BK virus‐associated hemorrhagic cystitis in children after second or third allogeneic hematopoietic stem cell transplantation
Author(s) -
Umeda Katsutsugu,
Kato Itaru,
Kawaguchi Koji,
Tasaka Keiji,
Kamitori Tatsuya,
Ogata Hideto,
Mikami Takashi,
Hiramatsu Hidefumi,
Saito Ryoichi,
Ogawa Osamu,
Takahashi Takayuki,
Adachi Souichi
Publication year - 2018
Publication title -
pediatric transplantation
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.457
H-Index - 69
eISSN - 1399-3046
pISSN - 1397-3142
DOI - 10.1111/petr.13183
Subject(s) - medicine , bk virus , cumulative incidence , hemorrhagic cystitis , incidence (geometry) , hematopoietic stem cell transplantation , complication , risk factor , transplantation , gastroenterology , surgery , immunology , kidney transplantation , physics , optics
BKV ‐ HC is a serious complication of allogeneic HSCT . To characterize the incidence, risk factors, and clinical outcomes of post‐ HSCT BKV ‐ HC , we retrospectively analyzed 112 patients who underwent one or more allogeneic HSCT s at our hospital between 2001 and 2017. Twenty underwent second or third HSCT thereafter. Ten patients developed BKV ‐ HC at a median of 30 days after HSCT . The 100‐day cumulative incidences of grade 0‐4 and grade 2‐4 BKV ‐ HC were 7.8% and 6.2%, respectively. HSCT s performed in 2011‐2017 associated with significantly higher 100‐day cumulative incidence of grade 2‐4 BKV ‐ HC (14.0%) than HSCT s performed in 2001‐2010 (1.3%, P = 0.004). On multivariate analysis, second or third HSCT was the only independent significant risk factor for development of grade 2‐4 BKV ‐ HC ( P = 0.015). Serial PCR monitoring of urine and blood BKV load did not predict BKV ‐ HC . The recent increase in the incidence of BKV ‐ HC may reflect recent innovations in transplant technologies that facilitate second or third HSCT , which are known to cause prolonged immune deficiency. If safe and effective treatment or prophylaxis becomes available, it could be used to target the high‐risk patients for BKV ‐ HC .