Effectiveness of hyperbaric oxygen therapy for virus-associated hemorrhagic cystitis after allogeneic hematopoietic stem cell transplantation

Hosokawa, Kohei; Aoki, Go; Ohata, Kinya; Takamatsu, Hiroyuki; Nakagawa, Noboru; Imi, Tatsuya; Iwaki, Noriko; Ito, Kiyoaki; Kawano, Mitsuhiro; Nakamura, Takashi; Takamori, Masato; Ishiyama, Ken; Kondo, Yukio; Yamazaki, Hirohito; Nakao, Shinji

doi:10.1007/s12185-021-03120-y

Cited by 8 publications

(3 citation statements)

References 30 publications

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“…Patients receiving HBOT had a faster median time to complete resolution (14.5 days vs 24 days) and a higher response rate (100% vs 62.5%) when compared to the control group. No severe HBOT-related adverse effects were noted [16]. Case reports have reported similar promising results [17,18].…”

Section: Introductionmentioning

confidence: 67%

Untitled

2024

GJPNC

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BK virus is one of several polyomaviruses capable of causing clinically significant infection in humans. Infection is asymptomatic, but reactivation in immunocompromised patients can cause significant clinical illness: hemorrhagic cystitis in hematopoietic stem cell transplant recipients and nephropathy in renal transplant recipients. The primary management of BK virus disease in immunocompromised patients is reduction of immunosuppression. We review the current landscape of active treatment of BK virus disease in immunocompromised patients.

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Section: Introductionmentioning

confidence: 67%

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2024

GJPNC

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“…Haemorrhagic cystitis is a common complication after HSCT, in which the patient’s age at the time of allo-HSCT, the type of transplantation, GVHD and viral infection have some correlation with HC development [ 14 ]. Severe HC leads to bladder clot blockage when the condition is not relieved after conservative treatment, and clot retention places the patient at risk of persistent bleeding and urinary tract infection.…”

Section: Discussionmentioning

confidence: 99%

Safety and efficacy of percutaneous electrocoagulation haemostasis in the treatment of grade IV haemorrhagic cystitis after allogeneic haematopoietic stem cell transplantation in children: a retrospective analysis

Liu¹,

Yang²,

Zhang

et al. 2023

Ital J Pediatr

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Background To investigate the efficacy and safety of endoscopic electrocoagulation haemostasis via a percutaneous transhepatic approach for the treatment of grade IV haemorrhagic cystitis (HC) after allogeneic haematopoietic stem cell transplantation (allo-HSCT) in children. Methods The clinical data of 14 children with severe HC, who were admitted to Hebei Yanda Hospital between July 2017 and January 2020, were analysed retrospectively. There were nine males and five females, with an average age of 8.6 years (range: 3 to 13 years). After an average of 39.6 (7 to 96) days of conservative treatment in the hospital’s haematology department, the bladders of all patients were filled with blood clots. A small 2-cm incision was made in the suprapubic area to enter the bladder and quickly clear the blood clots, and a percutaneous transhepatic approach to electrocoagulation and haemostasis was performed. Results In the 14 children, a total of 16 operations were performed, with an average operation time of 97.1 (31 to 150) min, an average blood clot of 128.1 (80 to 460) mL and an average intraoperative blood loss of 31.9 (20 to 50) mL. There were three cases of postoperative bladder spasm remission after conservative treatment. During the follow-up period of 1 to 31 months, one patient improved after one operation, 11 patients were cured after one operation, and two patients were cured after recurrent haemostasis by secondary electrocoagulation, four of whom died of postoperative non-surgical blood-related diseases and severe lung infections. Conclusion Percutaneous electrocoagulation haemostasis can quickly remove blood clots in the bladders of children after allo-HSCT with grade IV HC. It is a safe and effective minimally invasive treatment.

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“…The remaining 14 studies analyzed (46.7%) used diagnostic definitions of BK-HC which differed from the ECIL triad (Table 1) (13,(30)(31)(32)(33)(34)(35)(36)(37)(38)(39)(40)(41)(42). Six of these studies included pediatric patients, including two which were exclusively in children.…”

Section: Application Of Diagnostic Definitions Of Bk-hc Differing Fro...mentioning

confidence: 99%

BK virus-associated hemorrhagic cystitis in pediatric stem cell transplantation: a case report and scoping review

Moss,

Muller

2024

Front. Pediatr.

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IntroductionBK virus-associated hemorrhagic cystitis (BK-HC) is a debilitating and poorly understood complication of hematopoietic stem cell transplantation (SCT). Hematuria, dysuria, and other symptoms associated with BK-HC are common in the immediate post-SCT period, making BK-HC difficult to distinguish from other conditions presenting with these symptoms. Despite published criteria for diagnosis, the degree to which these criteria are consistently applied to either clinical diagnosis or to studies informing BK-HC management is unclear. We present a case of BK-HC in a pediatric SCT recipient, and discuss the challenges associated with treatment in the absence of rigorous data to inform clinical management.MethodsWe reviewed all cases of BK viruria at our center in patients undergoing SCT between January 2015 and December 2019. We then performed a scoping review of publications in PubMed addressing BK-HC, specifically focusing on how BK-HC was defined. Publications using the keywords “BK polyomavirus” and “hemorrhagic cystitis” were included if they involved a clinical study of SCT recipients and a full-text article was available in English. Case reports were excluded. Analysis focused on whether BK-HC was explicitly defined and whether the definition incorporated elements of diagnostic criteria published by European Conference on Infections in Leukemia (ECIL).ResultsA total of 30 studies published between January 2018 and 30 June 2021 met criteria for review, including 4 clinical trials, 7 prospective observational studies, and 19 retrospective observational studies. Fifteen of these studies included pediatric patients (7 pediatric only, 8 combined adult and pediatric). Of the 30 publications, 19 included a definition of either BK-HC or BK cystitis, with only five using ECIL criteria, all of which were observational studies. Multiple interventions are described for treatment of BK-HC, including cidofovir, leflunomide, quinolones, hyperbaric oxygen, keratinocyte growth factor, and BK-specific cytotoxic T lymphocytes. However, evidence to support efficacy for any of these interventions is lacking.DiscussionAlthough BK-HC is a well-known complication of SCT, evidence to support available treatment options is limited. Well-controlled studies that incorporate clear diagnostic criteria are needed to better define the risk factors, natural history, and ideal interventions.

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Effectiveness of hyperbaric oxygen therapy for virus-associated hemorrhagic cystitis after allogeneic hematopoietic stem cell transplantation

Cited by 8 publications

References 30 publications

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Safety and efficacy of percutaneous electrocoagulation haemostasis in the treatment of grade IV haemorrhagic cystitis after allogeneic haematopoietic stem cell transplantation in children: a retrospective analysis

BK virus-associated hemorrhagic cystitis in pediatric stem cell transplantation: a case report and scoping review

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