Recombinant activated factor VII to control life-threatening haemorrhagic radiation cystitis

Connolly, Sheelah; D’Arcy, Frank; Corcoran, M.

doi:10.1007/s11845-009-0324-6

Cited by 12 publications

(6 citation statements)

References 9 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Several therapies were evaluated including chondroitin sulfate, sodium hyaluronate, prostaglandins (PGE1, PGE2, PGF2α), formalin, and alum irrigation but results were not satisfactory [8][9][10]. Systemic treatments, e.g., estrogen, sodium pentosanpolysulphate, recombinant factor VIIa or VIII, and aminocapronic acid have been used with some successful results but toxic effects were observed [8,[11][12][13]. The new data about the role of mesenchymal stromal cells (MSC) in the treatment of HC after alloHSCT revealed promising clinical results.…”

Section: Discussionmentioning

confidence: 99%

The use of hyperbaric oxygen therapy in the treatment of hemorrhagic cystitis after allogeneic stem cell transplantation from an unrelated donor

et al. 2015

View full text Add to dashboard Cite

Hemorrhagic cystitis (HC) is a diffuse inflammation of the bladder of an infectious or non-infectious etiology, causing bleeding of the bladder mucosa. There are no explicit guidelines defining the appropriate treatment of HC. Hyperbaric oxygen therapy (HBO) is a non-invasive method involving the use of 100 % oxygen under increased pressure, which penetrates to poorly perfused areas. The most appropriate group for treatment with HBO is patients with BK virus-associated HC after allogenic human stem cell transplantation (alloHSCT). In this report, we present five patients after alloHSCT from a matched unrelated donor with symptoms of HC successfully treated with HBO. All patients received therapy with 100 % oxygen in a hyperbaric chamber at 2.5 atmospheres for 60 min, delivered 5 days per week. Complete response with resolution of pain and hematuria, as well as eradication of viral load, was achieved by all the patients after a mean of 13 sessions (range 11-30) of HBO. These data indicate that HBO therapy is sufficient and effective in the treatment of HC, and represents a well-tolerated procedure with good clinical and laboratory results after ineffective primary treatment.

show abstract

Section: Discussionmentioning

confidence: 99%

The use of hyperbaric oxygen therapy in the treatment of hemorrhagic cystitis after allogeneic stem cell transplantation from an unrelated donor

et al. 2015

View full text Add to dashboard Cite

show abstract

“…One reported a 63-year-old woman treated with radiotherapy for rectal carcinoma, who developed a lifethreatening HC refractory to hyperbaric oxygen therapy, alum irrigation and sodium pentosanpolysulphate. After 10 days of daily IV administration of factor VII, 30 lg/kg, the bleeding finally stopped [36]. A 29-year-old woman with cervical cancer also suffering from a life-threatening radiation-induced HC refractory to formalin and silver nitrate also responded to recombinant factor VII, which stopped the bleeding [37].…”

Section: Systemic Treatmentmentioning

confidence: 99%

A Practical Approach to the Management of Radiation-Induced Hemorrhagic Cystitis

Liem

Saad

Delouya

2015

Drugs

View full text Add to dashboard Cite

Radiation-induced hemorrhagic cystitis (HC) is a complication of pelvic radiotherapy, mainly for prostate and uterine cancers. In the acute phase, patients feel urinary urgency and bladder pain. This phase is reversible after radiotherapy. In the chronic stage, an irritative syndrome is coupled with hematuria during the 2-10 years following radiotherapy. Cystoscopy shows white and frosted mucosa with telangiectasia. The incidence is estimated at 5 % or less. It is suggested that the radiation oncologist reviews the dosimetry plan to validate that the lesions coincide with significant radiation exposure confirming diagnosis of radiation-induced HC. The treatment for HC is first symptomatic, with bladder lavage, clot evacuation, coagulation via cystoscopy and blood transfusions if necessary. Subsequently, hyaluronic acid bladder instillation can be done with little toxicity. Hyperbaric oxygen therapy delivers pure oxygen to patients in a pressurized cabin, promoting angio-neogenesis and lowering hypoxia to the irradiated tissues. The clinical response rate is estimated to be around 80 %. Nevertheless, this approach is limited by the low availability, and length of treatment. While surgery remains an effective treatment for HC, it is the last option because of the high morbidity and mortality risks. Prospective studies need to be conducted to identify and evaluate new interventions, particularly for HC.

show abstract

“…Thereafter, a variety of therapeutic options are available if the hematuria is persistent. 1,3,[8][9][10][11][12][13][14][15][16][17][18][19][20][21][22][23] Following is a discussion of some of these alternatives. A small proportion of patients with HRC has severe, refractory, life-threatening hematuria and may require urinary diversion alone or combined with cystectomy.…”

Section: Managementmentioning

confidence: 99%

Hemorrhagic Radiation Cystitis

Mendenhall

Henderson

Costa

et al. 2015

American Journal of Clinical Oncology

View full text Add to dashboard Cite

The optimal management of persistent hemorrhagic radiation cystitis is ill-defined. Various options are available and include oral agents (ie, sodium pentosan polysulfate), intravenous drugs (ie, WF10), topical agents (ie, formalin), hyperbaric oxygen, and endoscopic procedures (ie, electrical cautery, argon plasma coagulation, laser coagulation). In general, it is best to manage patients conservatively and intervene only when necessary with the option least likely to exacerbate the cystitis. More aggressive measures should be employed only when more conservative approaches fail. Bladder biopsies should be avoided, unless findings suggest a bladder tumor, because they may precipitate a complication.

show abstract

Recombinant activated factor VII to control life-threatening haemorrhagic radiation cystitis

Abstract: This therapy deserves mention in any future management algorithm devised for this condition.

Cited by 12 publications

References 9 publications

The use of hyperbaric oxygen therapy in the treatment of hemorrhagic cystitis after allogeneic stem cell transplantation from an unrelated donor

The use of hyperbaric oxygen therapy in the treatment of hemorrhagic cystitis after allogeneic stem cell transplantation from an unrelated donor

A Practical Approach to the Management of Radiation-Induced Hemorrhagic Cystitis

Hemorrhagic Radiation Cystitis

Contact Info

Product

Resources

About