BKV Related Hemorrhagic Cystitis—An Insight into Risk Factors and Later Complications—An Analysis on Behalf of Polish Adult Leukemia Group
by
, , , , ,
Jarosław Dybko
1,*
,
Agnieszka Piekarska
2,
Siddarth Agrawal
3,
Sebastian Makuch
4,
Donata Urbaniak-Kujda
5,
Monika Biernat
5,
Blanka Rybka
6,
Magdalena Dutka
2,
Alicja Sadowska-Klasa
2,
Sebastian Giebel
7 and
Lidia Gil
8 1
Department of Hematology and Cellular Transplantation, Lower Silesian Oncology Center, 53-413 Wroclaw, Poland
2
Department of Hematology and Transplantology, Medical University of Gdansk, 80-214 Gdansk, Poland
3
Department and Clinic of Internal Medicine, Occupational Diseases, Hypertension and Clinical Oncology, Wroclaw Medical University, 50-556 Wroclaw, Poland
4
Department of Clinical and Experimental Pathology, Wroclaw Medical University, 50-368 Wroclaw, Poland
5
Department of Hematology and Bone Marrow Transplantation, Wroclaw Medical University, 50-367 Wroclaw, Poland
6
Department of Pediatric Bone Marrow Transplantation, Oncology, and Hematology, Wroclaw Medical University, 50-556 Wroclaw, Poland
7
Department of Bone Marrow Transplantation and Hematology-Oncology, National Research Institute of Oncology, 44-102 Gliwice, Poland
8
Department of Hematology and Bone Marrow Transplantation, Poznań University of Medical Sciences, 60-569 Poznan, Poland
*
Author to whom correspondence should be addressed.
Cancers 2022, 14(3), 764; https://doi.org/10.3390/cancers14030764
Submission received: 29 December 2021
/
Revised: 26 January 2022
/
Accepted: 27 January 2022
/
Published: 1 February 2022
(This article belongs to the Special Issue Autologous and Allogeneic Stem Cell Transplant in Cancer Therapy)
Simple Summary
Despite noticeable progress in allogeneic hematopoietic stem cell transplantation, potential viral reactivations are still one of the most challenging complications. The aim of our study was to identify predictive and risk factors associated with the occurrence of the BK virus related hemorrhagic cystitis following hematopoietic stem cell transplantation. Furthermore, we investigated the impact of various factors on the clinical course of patients after hematopoietic stem cell transplantation. We confirmed that >0.75 × 103 BK virus copies/mL in serum at day +21 after allogeneic hematopoietic stem cell transplantation has a strong predictive ability for hemorrhagic cystitis. Thus, we believe that our findings could be helpful in establishing the predictive validity of the BK viral load measurement in polyomavirus BK-associated hemorrhagic cystitis and survival.
Abstract
BK virus reactivation increases the likelihood of hemorrhagic cystitis (HC) after allogeneic hematopoietic stem cell transplant (HCT). In this study, we aimed to identify predictive and risk factors associated with the increased occurrence of this condition following HCT. On a group of 124 patients aged ≤71 years old (median 40 years) who underwent HCT, we analyzed sex, age, time from diagnosis to transplantation, type of conditioning, donor’s relationship, age, and sex, the impact of immunosuppression with different drugs, and acute and chronic GVHD, BK viremia and viruria as potential factors increasing the risk of BK-related HC after HCT. HC occurred among 24 patients (24/124; 29.2%). A significant correlation was observed between HC incidences after HCT, BK viremia and viruria, and acute GVHD occurrence. Furthermore, the level of BKV DNA in serum at day +21 (>0.75 × 103) significantly impacted the patients’ survival time. According to our results, the likelihood ratio of BKV-DNA on day +21 in serum is 6.25, indicating that this diagnostic test has the potential to be utilized in a clinical setting. These findings may be used as a voice in the discussion on implementing an optimal preemptive treatment in BKV reactivation after allogeneic HCT.
