J Korean Med Sci.  2003 Apr;18(2):191-195. 10.3346/jkms.2003.18.2.191.

Hemorrhagic Cystitis Following Allogeneic Hematopoietic Cell Transplantation

• Lee GW
• Lee JH
• Choi SJ
• Kim S
• Seol M
• Kim WK
• Lee JS
• Lee KH

• KMID: 2157621
• DOI: http://doi.org/10.3346/jkms.2003.18.2.191

Abstract

We conducted a retrospective study to investigate the incidence, risk factors, and clinical features of hemorrhagic cystitis (HC) following allogeneic hematopoietic cell transplantation (allo-HCT). Adult patients who developed HC after allo-HCT were identified from the HCT database of the Asan Medical Center and their medical records were reviewed. From December 1993 to August 2001, a total of 210 adult patients underwent allo-HCT. Fifty-one patients developed HC with a cumulative incidence of 25.7%. The median onset of HC was post-transplant day 24 (range, -2 to 474), and the median duration was 31 days (range, 8 to 369). Significant risk factors for HC by univariate analysis included diagnosis of chronic myelogenous leukemia (p=0.028), unrelated HCT (p=0.029), grade III-IV acute graft-versus-host disease (GVHD) (p<0.001), extensive chronic GVHD (p=0.001), and positive cytomegalovirus antigenemia between post transplant days 31 and 60 (p=0.031). Multivariate analysis showed that grade III-IV acute GVHD was the most important risk factor for the occurrence of HC after allo-HCT (odds ratio, 3.38; 95% CI, 1.36-8.39). Late-onset HC, which occurred beyond 3 weeks after allo-HCT, was more frequently associated with GVHD than earlyonset HC (p=0.007). Our data suggest that a portion of late-onset HC might be a manifestation of GVHD.

Keyword

Cytomegalovirus Cystitis; Hematopoietic Stem Cell Transplantation; Graft vs Host Disease

MeSH Terms

Adult
Cystitis/epidemiology
Cystitis/etiology*
Cystitis/pathology
Female
Graft vs Host Disease/complications
Graft vs Host Disease/pathology
Hematopoietic Stem Cells/physiology*
Hemorrhagic Disorders/epidemiology
Hemorrhagic Disorders/etiology*
Hemorrhagic Disorders/pathology
Human
Male
Multivariate Analysis
Retrospective Studies
Risk Factors
Stem Cell Transplantation/adverse effects*
Transplantation Conditioning