首页|期刊导航|中华医学杂志（英文版）|Hemorrhagic cystitis following hematopoietic stem cell transplantation: incidence, risk factors and association with CMV reactivation and graft-versus-host disease
Hemorrhagic cystitis following hematopoietic stem cell transplantation: incidence, risk factors and association with CMV reactivation and graft-versus-host disease
XU Lan-ping ZHANG Yao-chen LU Dao-pei ZHANG Hong-yu HUANG Xiao-jun LIU Kai-yan LIU Dai-hong HAN Wei CHEN Huan CHEN Yu-hong GAO Zhi-yong
中华医学杂志（英文版）2007，Vol.120Issue(19)：1666-1671,6.
中华医学杂志（英文版）2007，Vol.120Issue(19)：1666-1671,6.
Hemorrhagic cystitis following hematopoietic stem cell transplantation: incidence, risk factors and association with CMV reactivation and graft-versus-host disease
Hemorrhagic cystitis following hematopoietic stem cell transplantation: incidence, risk factors and association with CMV reactivation and graft-versus-host disease
摘要
Abstract
Background The definite pathogenesis of hemorrhagic cystitis (HC) after allogenic hematopoietic stem cell transplantation (allo-HSCT) has not been well elucidated. The role of cytomegalovirus (CMV) reactivation and graft-versus-host disease (GVHD) in the development of HC remains obscure. This study determined the incidence and risk factors for HC after allo-HSCT and analyzed its association with CMV reactivation and GVHD. Methods We retrospectively studied 250 patients at high risk for CMV disease who underwent allo-HSCT all based on busulfan/cyclophosphamide (BU/CY) myloablative regimens. The incidence, etiology, risk factors and clinical management of HC were investigated.Results HC developed within 180 days of transplant in 72 patients, with an overall incidence of 28.8% and an incidence of 12.6% in patients with HLA-matched related donors (MRD), 34.38% in those with HLA-matched unrelated donors (MUD), 49.45% in those with mismatched related donors (MMRD). CMV-viremia significantly increased the incidence of later onset HC (LOHC); however, only 9 out of 15 patients with CMV viruria actually developed LOHC. Multiple regression analysis identified grade Ⅱ-Ⅳ acute GVHD (RR=2.75; 95% CI 1.63-4.66; P＜0.01) and grafts from MUD or MMRD (RR=2.60; 95% CI 1.52-5.20; P＜0.01) as independent risk factors for HC. Event sequence analysis indicated a majority of HC episodes began around GVHD initiation.Conclusions CMV-viremia is a high risk factor for LOHC. Our data also showed a correlation between acute GVHD and HC, which suggested that alloimmunity may be involved in the pathogenesis of HC.关键词
hemorrhagic cystitis/ allogeneic hematopoietic stem cell transplantation/ cytomegalovirus/graft-versus-host diseaseKey words
hemorrhagic cystitis/ allogeneic hematopoietic stem cell transplantation/ cytomegalovirus/graft-versus-host disease分类
医药卫生引用本文复制引用
XU Lan-ping,ZHANG Yao-chen ,LU Dao-pei ,ZHANG Hong-yu,HUANG Xiao-jun,LIU Kai-yan,LIU Dai-hong,HAN Wei,CHEN Huan,CHEN Yu-hong,GAO Zhi-yong..Hemorrhagic cystitis following hematopoietic stem cell transplantation: incidence, risk factors and association with CMV reactivation and graft-versus-host disease[J].中华医学杂志（英文版）,2007,120(19):1666-1671,6.基金项目
This work is supported by the grants from the Scientific Research fund for Capital Medicine Development (No. 2006-1010) and the Hi-Tech Research and Development Program of China (No.2006AA02Z4A0). （No. 2006-1010）
