[Hemorrhagic cystitis related to the high-dose conditioning therapy in a bone marrow recipient].
Hemorrhagic cystitis (HC) is the syndrome of hematuria combined with symptoms of lower urinary tract irritation in the absence of bacterial infection or generalized hemorrhagic diathesis. HC often occurs as a difficult complication after autologous as well as allogeneic hematopoietic cell transplantation (HCT). It may be secondary to pretransplant preparative regimen (chemotherapy and/or radiation therapy) or viral infection by adenovirus, JC and BK viruses. The most effective treatment for HC has not been established yet. We report a case of a 17-year-old male with common acute lymphoblastic leukemia (cALL) in second CR, who was treated with high-dose chemotherapy (BuCy conditioning regimen) followed by autologous bone marrow transplantation (ABMT), complicated by hemorrhagic cystitis on day 0 (several hours after infusion of transplant material). The immediate use of increased dose of 2-mercaptoethane sulfonate sodium (mesna), bladder irrigation and intensive hydration with forced diuresis resulted in resolution of macroscopic hematuria on day +3 after the transplant and urinary tract recovery with normalization of urine analysis parameters on day +7.
Machaczka
M
M
Katedra i Klinika Hematologii CM UJ 31-501 Kraków, ul. Kopernika 17. machaczka@endo.cm-uj.krakow.pl
Rucińska
M
M
Piatkowska-Jakubas
B
B
Załuska
A
A
Skotnicki
A B
AB
D000293:Adolescent; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000009:adverse effects*; D016026:Bone Marrow Transplantation; D002066:Busulfan / Q000009:adverse effects*; D003520:Cyclophosphamide / Q000009:adverse effects*; D006417:Hematuria / Q000139:chemically induced* / Q000188:drug therapy; D006801:Humans; D007945:Leukemia, Lymphoid / Q000628:therapy; D008297:Male; D015080:Mesna / Q000627:therapeutic use; D011292:Premedication / Q000009:adverse effects*
D003520:Cyclophosphamide; D002066:Busulfan; D015080:Mesna