title: Hematuria due to adenoviral infection in bone marrow transplant recipients.
abstract: Late-onset hemorrhagic cystitis (HC) caused by adenovirus (AdV) infection is a common complication in hematopoietic stem cell transplantation (HSCT) recipients. However, limited information exists regarding adenovirus-associated HC. We report a retrospective study of 84 hematopoietic stem cell transplant recipients that evaluated the incidence and risk factors for AdV-induced HC. The development of HC was strongly related to adenoviral infection (P = .004). Among 13 patients who developed late-onset HC, AdVs were identified as a causative agent in 10 cases. AdV preferentially affected younger (P = .013) and male patients. Affected subjects had been transplanted for either malignant (7/10) or nonmalignant disorders (3/10). Most cases of AdV-hematuria were self-limited single or recurrent mild hemorrhagic episodes (P = .000), occurring at a median of 41 days after transplantation and lasting an average of 4 days. Viral load in patients with AdV-induced HC was similar to infected subjects who did not develop HC (2.5 × 10(3) vs 3.4 × 10(3) copies/mL). We HC occurring before 200 days was associated with a greater risk of a fatal outcome (P = .002) but occurrence of AdV infection did not affect a patient's survival. Our study confirmed the suggestion that non-AdV coinfections may worsen the course of AdV-HC.
authors.affiliation: Department of Clinical Chemistry, University of Medicine, Wrocław, Poland.
authors.forename: I
authors.initials: I
authors.lastname: Bil-Lula
authors.forename: M
authors.initials: M
authors.lastname: Ussowicz
authors.forename: B
authors.initials: B
authors.lastname: Rybka
authors.forename: D
authors.initials: D
authors.lastname: Wendycz-Domalewska
authors.forename: R
authors.initials: R
authors.lastname: Ryczan
authors.forename: E
authors.initials: E
authors.lastname: Gorczyńska
authors.forename: K
authors.initials: K
authors.lastname: Kałwak
authors.forename: M
authors.initials: M
authors.lastname: Woźniak
mesh_terms: D000256:Adenoviridae / Q000235:genetics / Q000302:isolation & purification*; D000257:Adenoviridae Infections / Q000175:diagnosis / Q000401:mortality / Q000821:virology*; D000293:Adolescent; D000328:Adult; D016026:Bone Marrow Transplantation / Q000009:adverse effects* / Q000401:mortality; D016009:Chi-Square Distribution; D002648:Child; D002675:Child, Preschool; D003556:Cystitis / Q000401:mortality / Q000821:virology*; D004279:DNA, Viral / Q000302:isolation & purification; D005260:Female; D018380:Hematopoietic Stem Cell Transplantation / Q000009:adverse effects* / Q000401:mortality; D006417:Hematuria / Q000401:mortality / Q000821:virology*; D006470:Hemorrhage / Q000401:mortality / Q000821:virology*; D006801:Humans; D015994:Incidence; D007223:Infant; D053208:Kaplan-Meier Estimate; D008297:Male; D011044:Poland; D016133:Polymerase Chain Reaction; D016016:Proportional Hazards Models; D012189:Retrospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D013997:Time Factors; D016896:Treatment Outcome; D019562:Viral Load; D055815:Young Adult
chemical_list: D004279:DNA, Viral