Incidence and treatment of hemorrhagic cystitis in children given hematopoietic stem cell transplantation: a survey from the Italian association of pediatric hematology oncology-bone marrow transplantation group.
The purpose of this multicenter study was to assess the incidence and the treatment of hemorrhagic cystitis (HC) in 1218 pediatric patients, with a mean age of 10.8 years, who underwent hematopoietic stem cell transplantation (HSCT). In all, 44 patients (3.6%) developed HC a median 23 days after HSCT. The incidence of HC was higher in allogeneic than in autologous HSCT recipients (P=0.0001). Of the 44 patients, 37 (84%) recovered from HC in a median 30 days (range 3-100); the other seven children died while still suffering from HC. Hyperbaric oxygen therapy (HOT) achieved significantly better results than prostaglandin therapy (P=0.02) in the treatment of grade II-III HC. By multivariate analysis, age <96 months and allogeneic HSCT were significantly associated with the occurrence of HC: P=0.008 and 0.013, respectively. After a median follow-up of 5.75 years, the 5-year survival of patients who did or did not develop HC was: 43 vs 52%, P=0.03, respectively. This study indicates that age and type of HSCT are factors predisposing to HC in children given HSCT and demonstrates the promising role of HOT in a conservative approach to HC treatment.
Cesaro
S
S
Clinica di Oncoematologia Pediatrica, Dipartimento di Pediatria, Università di Padova, Padova, Italy. simone.cesaro@unipd.it
Brugiolo
A
A
Faraci
M
M
Uderzo
C
C
Rondelli
R
R
Favre
C
C
Zecca
M
M
Garetto
G
G
Dini
G
G
Pillon
M
M
Messina
C
C
Zanesco
L
L
Pession
A
A
Locatelli
F
F
D000293:Adolescent; D000367:Age Factors; D002648:Child; D002675:Child, Preschool; D003556:Cystitis / Q000209:etiology* / Q000628:therapy*; D003625:Data Collection; D005260:Female; D018380:Hematopoietic Stem Cell Transplantation / Q000009:adverse effects* / Q000401:mortality; D006470:Hemorrhage; D006801:Humans; D006931:Hyperbaric Oxygenation; D015994:Incidence; D007558:Italy; D008297:Male; D015999:Multivariate Analysis; D011453:Prostaglandins / Q000627:therapeutic use; D012189:Retrospective Studies; D016019:Survival Analysis; D014182:Transplantation, Autologous / Q000009:adverse effects; D014184:Transplantation, Homologous / Q000009:adverse effects; D016896:Treatment Outcome
D011453:Prostaglandins