Outpatient haploidentical hematopoietic stem cell transplant using post-transplant cyclophosphamide and incidence of hemorrhagic cystitis

Cesar Homero Gutiérrez-Aguirre, Alejandra Celina Esparza-Sandoval, Alain Palomares-Leal, José Carlos Jaime-Pérez, David Gómez-Almaguer, Olga Graciela Cantú-Rodríguez, Cesar Homero Gutiérrez-Aguirre, Alejandra Celina Esparza-Sandoval, Alain Palomares-Leal, José Carlos Jaime-Pérez, David Gómez-Almaguer, Olga Graciela Cantú-Rodríguez

Abstract

Introduction: Hemorrhagic cystitis (HC) is a common complication of haploidentical hematopoietic stem cell transplantation (haplo-HSCT), characterized by irritative symptoms of the urinary tract and a higher morbidity and mortality rate. The worldwide incidence is reported between 10% and 70%. The use of alkylating agents and BK viral infection are the most frequent etiologies. The aim of this study was to report the HC incidence in an outpatient haplo-HCST program with a reduced intensity-conditioning (RIC) regimen, cataloguing risk factors, complications and final outcomes.

Methods: The medical database of patients who received a haplo-HSCT between January 2012 and November 2017 was retrospectively analyzed. Demographic variables, general characteristics and HC incidence were included.

Results: One hundred and eleven patients were included, 30 (27%) of whom developed HC, most of them (70%) being grade II, with a 30-day (7-149) median time of post-transplant HC onset. The BK virus was detected in 71% of the urine samples analyzed. All HC patients responded to treatment, except two (6.6%), who died due to HC complications.

Conclusions: There was no difference in the HC incidence or severity, compared to that reported when performing haplo-HSCT in hospitalized patients, although the donor-recipient sex mismatch did relate to a higher HC incidence.

Keywords: BK virus; Hemorrhagic cystitis; Stem cell transplantation.

Copyright © 2022 Associação Brasileira de Hematologia, Hemoterapia e Terapia Celular. Published by Elsevier España, S.L.U. All rights reserved.

Figures

Figure 1
Figure 1
Overall survival of patients with and without hemorrhagic cystitis (HC).

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