title: Different risk factors related to adenovirus- or BK virus-associated hemorrhagic cystitis following allogeneic stem cell transplantation.
abstract: Virus-associated hemorrhagic cystitis (HC) is a major cause of morbidity and mortality following allogeneic hematopoietic stem cell transplantation (HSCT). Although numerous studies have attempted to identify factors that predispose patients to viral HC, its causes remain controversial. We analyzed retrospectively the results of 266 allogeneic HSCTs to identify factors associated with HC. Of this group, 42 patients (15.8%) were diagnosed with viral HC, because of either adenovirus (ADV; n = 26; 9.8%) or BK virus (BKV; n = 16; 6.0%). ADV-HC was frequently associated with T cell purging, and was less common in patients with acute graft-versus-host-disease (GVHD). Conversely, BKV-HC was more frequently observed in patients with excessive immune reactions such as GVHD, preengraftment immune reaction, and hemophagocytic syndrome. These observations indicate that ADV- and BKV-HC may differ significantly in their risk factors and pathogenesis. Profound immune deficiency is more likely to be associated with ADV-HC, whereas immune hyperactivity might play a key role in BKV-HC.
authors.affiliation: Department of Medicine and Biosystemic Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.
authors.forename: Yasuo
authors.initials: Y
authors.lastname: Mori
authors.forename: Toshihiro
authors.initials: T
authors.lastname: Miyamoto
authors.forename: Koji
authors.initials: K
authors.lastname: Kato
authors.forename: Kenjiro
authors.initials: K
authors.lastname: Kamezaki
authors.forename: Takuro
authors.initials: T
authors.lastname: Kuriyama
authors.forename: Seido
authors.initials: S
authors.lastname: Oku
authors.forename: Katsuto
authors.initials: K
authors.lastname: Takenaka
authors.forename: Hiromi
authors.initials: H
authors.lastname: Iwasaki
authors.forename: Naoki
authors.initials: N
authors.lastname: Harada
authors.forename: Motoaki
authors.initials: M
authors.lastname: Shiratsuchi
authors.forename: Yasunobu
authors.initials: Y
authors.lastname: Abe
authors.forename: Koji
authors.initials: K
authors.lastname: Nagafuji
authors.forename: Takanori
authors.initials: T
authors.lastname: Teshima
authors.forename: Koichi
authors.initials: K
authors.lastname: Akashi
mesh_terms: D000256:Adenoviridae / Q000302:isolation & purification; D000293:Adolescent; D000328:Adult; D000368:Aged; D001739:BK Virus / Q000302:isolation & purification; D003556:Cystitis / Q000209:etiology* / Q000821:virology; D003586:Cytomegalovirus Infections / Q000209:etiology* / Q000473:pathology; D005260:Female; D018380:Hematopoietic Stem Cell Transplantation / Q000009:adverse effects* / Q000379:methods; D006470:Hemorrhage / Q000209:etiology* / Q000821:virology; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D027601:Polyomavirus Infections / Q000209:etiology* / Q000473:pathology; D012189:Retrospective Studies; D012307:Risk Factors; D014184:Transplantation, Homologous; D014412:Tumor Virus Infections / Q000209:etiology* / Q000473:pathology; D055815:Young Adult