Haemorrhagic cystitis in haematopoietic stem cell transplantation (HSCT): A prospective observational study of incidence and management in HSCT centres within the GITMO network (Gruppo Italiano Trapianto Midollo Osseo)

G. Gargiulo, Laura Orlando, F. Alberani, G. Crabu, A. Di Maio, L. Duranti, A. Errico, S. Liptrott, R. Pitrone, S. Santarone, C. Soliman, A. Trunfio, C. Selleri, B. Bruno, S. Mammoliti, F. Pane

Research output: Contribution to journalArticle

Abstract

Haemorrhagic cystitis (HC) is a recognised complication in patients undergoing allogeneic haematopoietic stem cell transplantation (HSCT). This study evaluates the incidence and severity of HC in patients undergoing allogeneic HSCT during hospitalisation and within the first 100 days following transplant, looking at the use of prophylaxis, management of HC, outcomes at 100 days post transplant, and to identify any correlations between development of HC and the different conditioning regimens for transplant or HC prevention methods used. Results: Four hundred and fifty patients (412 adult and 38 paediatric) were enrolled in this prospective, multicentre, and observational study. HC was observed in 55 patients (12.2%) of which 8/38 were paediatric (21% of total paediatric sample) and 47/412 adults (11.4% of total adult sample). HC was observed primarily in the non-related HSCT group (45/55; 81.8%, p = 0.001) compared to sibling and myeloablative transplant protocols (48/55; 87.3%; p = 0.008) and with respect to reduced intensity conditioning regimens (7/55;12.7%). In 33 patients with HC (60%), BK virus was isolated in urine samples, a potential co-factor in the pathogenesis of HC. The median day of HC presentation was 23 days post HSCT infusion, with a mean duration of 20 days. The most frequent therapeutic treatments were placement of a bladder catheter (31/55; 56%) and continuous bladder irrigation (40/55; 73%). The range of variables in terms of conditioning regimens and so on, makes analysis difficult. Conclusions: This multi-centre national study reported similar incidence rates of HC to those in the literature. Evidence-based guidelines for prophylaxis and management are required in transplant centres. Further research is required to look at both prophylactic and therapeutic interventions, which also consider toxicity of newer conditioning regimens.

Original languageEnglish
Article number420
Journalecancermedicalscience
Volume8
Issue number1
DOIs
Publication statusPublished - Apr 10 2014

Fingerprint

Cystitis
Hematopoietic Stem Cell Transplantation
Observational Studies
Prospective Studies
Incidence
Transplants
Pediatrics
Urinary Bladder
BK Virus
Multicenter Studies
Siblings
Hospitalization
Cohort Studies
Therapeutics
Catheters
Urine
Guidelines

Keywords

  • Haemmorrhagic cystitis
  • HSCT

ASJC Scopus subject areas

  • Oncology
  • Cancer Research

Cite this

Haemorrhagic cystitis in haematopoietic stem cell transplantation (HSCT) : A prospective observational study of incidence and management in HSCT centres within the GITMO network (Gruppo Italiano Trapianto Midollo Osseo). / Gargiulo, G.; Orlando, Laura; Alberani, F.; Crabu, G.; Di Maio, A.; Duranti, L.; Errico, A.; Liptrott, S.; Pitrone, R.; Santarone, S.; Soliman, C.; Trunfio, A.; Selleri, C.; Bruno, B.; Mammoliti, S.; Pane, F.

In: ecancermedicalscience, Vol. 8, No. 1, 420, 10.04.2014.

Research output: Contribution to journalArticle

Gargiulo, G, Orlando, L, Alberani, F, Crabu, G, Di Maio, A, Duranti, L, Errico, A, Liptrott, S, Pitrone, R, Santarone, S, Soliman, C, Trunfio, A, Selleri, C, Bruno, B, Mammoliti, S & Pane, F 2014, 'Haemorrhagic cystitis in haematopoietic stem cell transplantation (HSCT): A prospective observational study of incidence and management in HSCT centres within the GITMO network (Gruppo Italiano Trapianto Midollo Osseo)', ecancermedicalscience, vol. 8, no. 1, 420. https://doi.org/10.3332/ecancer.2014.420
Gargiulo, G. ; Orlando, Laura ; Alberani, F. ; Crabu, G. ; Di Maio, A. ; Duranti, L. ; Errico, A. ; Liptrott, S. ; Pitrone, R. ; Santarone, S. ; Soliman, C. ; Trunfio, A. ; Selleri, C. ; Bruno, B. ; Mammoliti, S. ; Pane, F. / Haemorrhagic cystitis in haematopoietic stem cell transplantation (HSCT) : A prospective observational study of incidence and management in HSCT centres within the GITMO network (Gruppo Italiano Trapianto Midollo Osseo). In: ecancermedicalscience. 2014 ; Vol. 8, No. 1.
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abstract = "Haemorrhagic cystitis (HC) is a recognised complication in patients undergoing allogeneic haematopoietic stem cell transplantation (HSCT). This study evaluates the incidence and severity of HC in patients undergoing allogeneic HSCT during hospitalisation and within the first 100 days following transplant, looking at the use of prophylaxis, management of HC, outcomes at 100 days post transplant, and to identify any correlations between development of HC and the different conditioning regimens for transplant or HC prevention methods used. Results: Four hundred and fifty patients (412 adult and 38 paediatric) were enrolled in this prospective, multicentre, and observational study. HC was observed in 55 patients (12.2{\%}) of which 8/38 were paediatric (21{\%} of total paediatric sample) and 47/412 adults (11.4{\%} of total adult sample). HC was observed primarily in the non-related HSCT group (45/55; 81.8{\%}, p = 0.001) compared to sibling and myeloablative transplant protocols (48/55; 87.3{\%}; p = 0.008) and with respect to reduced intensity conditioning regimens (7/55;12.7{\%}). In 33 patients with HC (60{\%}), BK virus was isolated in urine samples, a potential co-factor in the pathogenesis of HC. The median day of HC presentation was 23 days post HSCT infusion, with a mean duration of 20 days. The most frequent therapeutic treatments were placement of a bladder catheter (31/55; 56{\%}) and continuous bladder irrigation (40/55; 73{\%}). The range of variables in terms of conditioning regimens and so on, makes analysis difficult. Conclusions: This multi-centre national study reported similar incidence rates of HC to those in the literature. Evidence-based guidelines for prophylaxis and management are required in transplant centres. Further research is required to look at both prophylactic and therapeutic interventions, which also consider toxicity of newer conditioning regimens.",
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AU - Di Maio, A.

AU - Duranti, L.

AU - Errico, A.

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AU - Pitrone, R.

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AU - Soliman, C.

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