Relationship of BK polyoma virus (BKV) in the urine with hemorrhagic cystitis and renal function in recipients of T Cell-depleted peripheral blood and cord blood stem cell transplantations.
Hematopoietic stem cell transplant (HSCT) recipients are at significant risk for BK virus (BKV) reactivation, hemorrhagic cystitis (HC), and renal dysfunction. We prospectively monitored 98 patients who had received HSCT by serial BKV PCR in the urine through day (D) +100 to analyze the relationship between BK viruria and HC, serum creatinine (Cr), and creatinine clearance (CrCl) through D +180 or death. Patients, median age 52 years (range, 20 to 73), received T cell-depleted (50%) or cord blood allografts (21%). Median pre-HSCT BKV IgG titers were 1:10,240. Incremental increase in BKV IgG titers correlated with developing BK viruria ≥ 10(7) copies/mL. By D +100, 53 (54%) patients had BK viruria. BKV load in the urine increased at engraftment and persisted throughout D +100. HC developed in 10 patients (10%); 7 of 10 with BK viruria. In competing risk analyses, BK viruria ≥ 10(7) copies/mL, older age, cytomegalovirus reactivation, and foscarnet use were risk factors for HC. Cr and CrCl at 2, 3, and 6 months after HSCT were similar between patients with and without BK viruria.
Department of Medicine, Infectious Disease, Memorial Sloan-Kettering Cancer Center, New York, New York.
Yeon Joo
YJ
Lee
Department of Epidemiology and Biostatistics, Memorial Sloan-Kettering Cancer Center, New York, New York.
Junting
J
Zheng
Department of Medicine, Infectious Disease, Memorial Sloan-Kettering Cancer Center, New York, New York.
Yovanna
Y
Kolitsopoulos
Department of Medicine, Infectious Disease, Memorial Sloan-Kettering Cancer Center, New York, New York.
Dick
D
Chung
Department of Medicine, Infectious Disease, Memorial Sloan-Kettering Cancer Center, New York, New York.
Isabelle
I
Amigues
Adult Bone Marrow Transplantation, Memorial Sloan-Kettering Cancer Center, New York, New York.
Tammy
T
Son
Adult Bone Marrow Transplantation, Memorial Sloan-Kettering Cancer Center, New York, New York.
Kathleen
K
Choo
Viracor-IBT Laboratories, Lee's Summit, Missouri.
Jeff
J
Hester
Adult Bone Marrow Transplantation, Memorial Sloan-Kettering Cancer Center, New York, New York; Department of Medicine, Weill Medical College, Cornell University New York, New York.
Sergio A
SA
Giralt
Department of Medicine, Weill Medical College, Cornell University New York, New York; Renal Services, Memorial Sloan-Kettering Cancer Center, New York, New York.
Ilya G
IG
Glezerman
Adult Bone Marrow Transplantation, Memorial Sloan-Kettering Cancer Center, New York, New York; Department of Medicine, Weill Medical College, Cornell University New York, New York.
Ann A
AA
Jakubowski
Department of Medicine, Infectious Disease, Memorial Sloan-Kettering Cancer Center, New York, New York; Department of Medicine, Weill Medical College, Cornell University New York, New York. Electronic address: papanicg@mskcc.org.
Genovefa A
GA
Papanicolaou
D000328:Adult; D000368:Aged; D001739:BK Virus / Q000254:growth & development / Q000472:pathogenicity*; D015331:Cohort Studies; D036101:Cord Blood Stem Cell Transplantation / Q000009:adverse effects*; D003556:Cystitis / Q000209:etiology* / Q000652:urine; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012307:Risk Factors; D013601:T-Lymphocytes / Q000821:virology; D055815:Young Adult
BK virus; Hematopoietic stem cell transplantation; Hemorrhagic cystitis; Renal function