title: Preventive measures for cyclophosphamide-related hemorrhagic cystitis in blood and bone marrow transplantation: an Italian multicenter retrospective study.
abstract: BACKGROUND
  Hemorrhagic cystitis (HC) is a troublesome and potentially life-threatening complication of bone marrow transplantation (BMT). HC can appear within a few hours after chemotherapy or after weeks or months. Early-onset HC (EOHC) is usually associated with the conditioning regimen.
  
  
  OBJECTIVE
  The main aim of this study was to describe the incidence of EOHC in patients undergoing BMT regimens including high-dose cyclophosphamide (CY) and the effects of the main preventive measures adopted in Italian nursing practice.
  
  
  METHODS
  The authors retrospectively analyzed the clinical records of 158 Italian patients who underwent BMT from 2006-2008.
  
  
  RESULTS
  Thirty-one patients (19.6%) developed EOHC. One hundred and forty-seven patients (93%) given high-dose CY were treated with hyperhydration combined with 2-mercaptoethane sulphonate (mesna) and diuresis alkalinization, and only 51 (32.3%) patients were preventively catheterized and received continuous bladder irrigation (CBI). By univariate analysis, prophylactic urethral catheterization and CBI did not decrease EOHC incidence questioning if these measures were to be routinely recommended. Previous studies showed increased discomfort and urinary tract infection in catheterized patients; therefore, nurses may fulfill an important role in balancing the benefits and harms of preventive catheterization and CBI in patients who received BMT conditioning including high-dose CY.
authors.affiliation: Università degli Studi di Verona in Verona, Italy.
authors.forename: Silvia
authors.initials: S
authors.lastname: Gonella
authors.forename: Tania
authors.initials: T
authors.lastname: di Pasquale
authors.forename: Alvisa
authors.initials: A
authors.lastname: Palese
mesh_terms: D000328:Adult; D016026:Bone Marrow Transplantation; D003520:Cyclophosphamide / Q000009:adverse effects*; D003556:Cystitis / Q000139:chemically induced / Q000517:prevention & control*; D006470:Hemorrhage / Q000139:chemically induced / Q000517:prevention & control*; D006801:Humans; D007166:Immunosuppressive Agents / Q000009:adverse effects*; D007558:Italy; D012189:Retrospective Studies; D007507:Therapeutic Irrigation; D019172:Transplantation Conditioning / Q000009:adverse effects; D014546:Urinary Catheterization
chemical_list: D007166:Immunosuppressive Agents; D003520:Cyclophosphamide
keywords: bone marrow transplantation; hemorrhage