title: Hemorrhagic cytitis after bone marrow transplantation.
abstract: OBJECTIVE
  Hemorrhagic cystitis (HC) presenting with gross hematuria, bladder pain and urinary frequency develops in 13-38% of patients following bone marrow transplantation (BMT). The objective of the study was to study the characteristics of patients suffering hemorrhagic cystitis after hematopoietic stem cell transplantation in our center.
  
  
  METHODS
  We conducted a retrospective chart review of all patients who underwent BMT at our institution between January 1996 and August 2012. We recorded the age, sex, diagnosis, conditioning regimen, interval between BMT and development of symptoms of cystitis and treatment instituted.
  
  
  RESULTS
  Five hundred patients underwent BMT in the period of time studied. 52 of them developed hemorrhagic cystitis. The mean age of the affected patients was 39 years; there were 34 males and 18 females. The diagnoses include AML (n=11), ALL (n=8), CML (n=6), MDS (n=11), CLL (n=5), NHL (n=1), HD (n=5), MM (n=2), Medular aplasia((n=3). HC appeared 59.48 days after BMT. There were no differences between sexes. Mortality among the 52 patients was 51.14% but HC was not the cause of death in any patient. Polyomaviruses were detected in the urine of 78.94 % of survivors.
  
  
  CONCLUSIONS
  Polyomavirus infection with BK and JC types is usually acquired in infancy and the virus remains latent in renal tissue. Immunosuppression facilitates reactivation of the renal infection and replication of the virus responsible for the clinical manifestations of HC. The differential diagnoses include other urinary infections, lithiasis, thrombocytopenia and adverse effects of pharmacological agents. The urologist plays a limited role in the management of this disease.
authors.affiliation: Servicio de Urologia. Hospital Universitario de Canarias. Canarias.Spain.
authors.forename: Barbara
authors.initials: B
authors.lastname: Padilla-Fernandez
authors.affiliation: Servicio de Hematologia. Hospital Universitario de Salamanca. Salamanca.Spain.
authors.forename: J M
authors.initials: JM
authors.lastname: Bastida-Bermejo
authors.affiliation: Servicio de Urologia. Hospital Universitario de Salamanca. Salamanca. Spain.
authors.forename: A J
authors.initials: AJ
authors.lastname: Virseda-Rodriguez
authors.affiliation: Servicio de Hematologia. Hospital Universitario de Salamanca. Salamanca.Spain.
authors.forename: J
authors.initials: J
authors.lastname: Labrador-Gomez
authors.affiliation: Servicio de Hematologia. Hospital Universitario de Salamanca. Salamanca.Spain.
authors.forename: D
authors.initials: D
authors.lastname: Caballero-Barrigon
authors.affiliation: Servicio de Urologia. Hospital de San pedro. Logroño. Logro˜o.La Rioja.Spain.
authors.forename: J M
authors.initials: JM
authors.lastname: Silva-Abuin
authors.affiliation: Servicio de Hematologia. Hospital Universitario de Salamanca. Salamanca.Spain.
authors.forename: J F
authors.initials: JF
authors.lastname: San Miguel-Izquierdo
authors.affiliation: Servicio de Urologia. Hospital Universitario de Salamanca. Salamanca. Spain.
authors.forename: M F
authors.initials: MF
authors.lastname: Lorenzo-Gomez
mesh_terms: D000328:Adult; D000368:Aged; D016026:Bone Marrow Transplantation / Q000009:adverse effects*; D003556:Cystitis / Q000209:etiology*; D005260:Female; D006417:Hematuria / Q000209:etiology; D006470:Hemorrhage / Q000209:etiology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010146:Pain / Q000209:etiology; D012189:Retrospective Studies; D055815:Young Adult