Recombinant factor VIIa to treat late radiation-induced hemorrhagic cystitis: a case report.
BACKGROUND
Late radiation cystitis is one of the most difficult complications of radiation therapy for pelvic malignancies.


METHODS
A 29-year-old woman with a history of cervical cancer presented with radiation-induced hemorrhagic cystitis. The patient received multiple units of packed red blood cells while undergoing several intravesical treatments, including continuous bladder irrigation, 4% formalin, 0.15% AgNO3 and Mg(OH)2 with Al(OH)3. The bleeding finally was stopped by the use of intravenous recombinant factor VIIa.


CONCLUSIONS
When hemorrhagic cystitis related to late radiation complications is refractory to conventional management, intravenous recombinant factor VIIa may be of benefit.
Division of Gynecologic Oncology, St. Vincent Hospitals, Indianapolis, Indiana, USA. jgeisler@indianawomensoncology.com
John P
JP
Geisler
Georgiann C
GC
Linnemeier
Kelly J
KJ
Manahan
D000328:Adult; D003556:Cystitis / Q000188:drug therapy* / Q000209:etiology*; D015942:Factor VIIa / Q000627:therapeutic use*; D005260:Female; D006470:Hemorrhage / Q000188:drug therapy* / Q000209:etiology*; D006801:Humans; D010386:Pelvic Neoplasms / Q000473:pathology / Q000532:radiotherapy*; D011878:Radiotherapy / Q000009:adverse effects; D011994:Recombinant Proteins / Q000627:therapeutic use
D011994:Recombinant Proteins; C103587:recombinant FVIIa; D015942:Factor VIIa