title: The use of hyperbaric oxygen therapy in the treatment of hemorrhagic cystitis after allogeneic stem cell transplantation from an unrelated donor.
abstract: Hemorrhagic cystitis (HC) is a diffuse inflammation of the bladder of an infectious or non-infectious etiology, causing bleeding of the bladder mucosa. There are no explicit guidelines defining the appropriate treatment of HC. Hyperbaric oxygen therapy (HBO) is a non-invasive method involving the use of 100 % oxygen under increased pressure, which penetrates to poorly perfused areas. The most appropriate group for treatment with HBO is patients with BK virus-associated HC after allogenic human stem cell transplantation (alloHSCT). In this report, we present five patients after alloHSCT from a matched unrelated donor with symptoms of HC successfully treated with HBO. All patients received therapy with 100 % oxygen in a hyperbaric chamber at 2.5 atmospheres for 60 min, delivered 5 days per week. Complete response with resolution of pain and hematuria, as well as eradication of viral load, was achieved by all the patients after a mean of 13 sessions (range 11-30) of HBO. These data indicate that HBO therapy is sufficient and effective in the treatment of HC, and represents a well-tolerated procedure with good clinical and laboratory results after ineffective primary treatment.
authors.affiliation: Department of Hematology, Neoplastic Blood Disorders and Bone Marrow Transplantation, Wroclaw Medical University, 4' Pasteur St, 50-367, Wroclaw, Poland.
authors.forename: Donata
authors.initials: D
authors.lastname: Urbaniak-Kujda
authors.forename: Katarzyna
authors.initials: K
authors.lastname: Kapelko-Słowik
authors.forename: Monika
authors.initials: M
authors.lastname: Biernat
authors.forename: Jarosław
authors.initials: J
authors.lastname: Dybko
authors.forename: Magdalena
authors.initials: M
authors.lastname: Laszkowska
authors.forename: Kazimierz
authors.initials: K
authors.lastname: Kuliczkowski
mesh_terms: D000328:Adult; D064591:Allografts; D003556:Cystitis / Q000209:etiology / Q000628:therapy*; D005260:Female; D018380:Hematopoietic Stem Cell Transplantation; D006470:Hemorrhage / Q000209:etiology / Q000628:therapy*; D006801:Humans; D006931:Hyperbaric Oxygenation; D008297:Male; D013997:Time Factors; D061349:Unrelated Donors