title: Higher proportions of peripheral CD19+CD5+ B cells predict the effect of corticosteroid in patients with late-onset hemorrhagic cystitis after allogeneic hematopoietic stem cell transplantation.
abstract: BACKGROUND
  The cause of late-onset hemorrhagic cystitis (LOHC) after allogeneic hematopoietic stem cell transplantation (allo-HSCT) remains obscure. In clinical practice, some LOHC patients respond to immunosuppression. The aim of this study was to determine the immune pathogenesis of LOHC post allo-HSCT.
  
  
  METHODS
  With the diagnosis of LOHC, patients were given initial treatment consisting of fluid hydration, alkalization and forced diuresis, and empirical anti-viral therapy for 10 - 14 days or until a week after the virus became negative. The nonresponders were applied corticosteroid. Seven to ten days later, patients' response was evaluated. Along with treatment, CD19(+) B lymphocyte subsets were measured at various study points.
  
  
  RESULTS
  From October 2009 to March 2010, we found 28 cases of LOHC occurred in 25 patients who underwent allo-HSCT in our hospital. Except that three cases were not treated according to the protocol, the other 25 cases were divided into three groups: anti-virus responders (Group A, n = 6), corticosteroid responders (Group B1, n = 16), corticosteroid and anti-virus nonresponders (Group C, n = 3) according to their clinical response. Percentages of CD19(+)CD5(+) B lymphocytes were not significantly different among three groups at onset of LOCH. However, in Group B1 after the first anti-virus phase, percentages of CD19(+)CD5(+) lymphocytes significantly increased comparing with those at onset (P = 0.022), and then significantly decreased at PR (P = 0.003) and CR (P = 0.002) with corticosteroid treatment. But significant change was not observed in Groups A and C.
  
  
  CONCLUSIONS
  The immune etiology seems to be involved in the development of LOHC and the proportion of CD19(+)CD5(+) lymphocytes may serve as a cellular biomarker to predict the response to corticosteroid in LOHC.
authors: Institute of Hematology, Peking University People's Hospital, Beijing 100044, China.
authors: Hai-Xia
authors: HX
authors: Fu
authors: Lan-Ping
authors: LP
authors: Xu
authors: Dai-Hong
authors: DH
authors: Liu
authors: Kai-Yan
authors: KY
authors: Liu
authors: Huan
authors: H
authors: Chen
authors: Wei
authors: W
authors: Han
authors: Xiao-Hui
authors: XH
authors: Zhang
authors: Yu
authors: Y
authors: Wang
authors: Feng-Rong
authors: FR
authors: Wang
authors: Jing-Zhi
authors: JZ
authors: Wang
authors: Ting
authors: T
authors: Zhao
authors: Yuan-Yuan
authors: YY
authors: Zhang
authors: Yao
authors: Y
authors: Chen
authors: Xiao-Jun
authors: XJ
authors: Huang
mesh_terms: D000293:Adolescent; D000305:Adrenal Cortex Hormones / Q000627:therapeutic use*; D000328:Adult; D018941:Antigens, CD19 / Q000378:metabolism*; D001402:B-Lymphocytes / Q000378:metabolism*; D018956:CD5 Antigens / Q000378:metabolism*; D002648:Child; D002675:Child, Preschool; D003556:Cystitis / Q000188:drug therapy* / Q000276:immunology / Q000628:therapy*; D005260:Female; D005434:Flow Cytometry; D018380:Hematopoietic Stem Cell Transplantation; D006801:Humans; D008297:Male; D008875:Middle Aged; D055815:Young Adult
chemical_list: D000305:Adrenal Cortex Hormones; D018941:Antigens, CD19; D018956:CD5 Antigens