title: A Prospective Study on the Predictive Value of Plasma BK Virus-DNA Load for Hemorrhagic Cystitis in Pediatric Patients After Stem Cell Transplantation.
abstract: BACKGROUND
  In hematopoietic stem cell transplantation (HSCT), late hemorrhagic cystitis (HC) has been associated with BK virus (BKV) infection. We assessed the value of plasma BKV load in predicting HC.
  
  
  METHODS
  Plasma and urine BKV-DNA load were assessed prospectively in 107 pediatric patients.
  
  
  RESULTS
  Twenty patients developed grade II and III HC, with 100-day cumulative incidence of 18.8%. At diagnosis of HC, the median load of BKV DNA was 2.3 × 10(3) copies/mL. A plasma BKV-DNA load of 10(3) copies/mL had a sensitivity of 100% and a specificity of 86% with a negative predictive value (NPV) of 100% and a positive predictive value (PPV) of 39% for HC. A urine BKV-DNA load of >10(7) copies/mL had a sensitivity of 86% and a specificity of 60% with a NPV of 98% and a PPV of 14% for HC. A BKV load of 10(3) copies/mL on plasma was significantly associated with HC in multivariate analysis (hazard ratio [HR], 6.1; P = .0006). Patients with HC had a significantly higher risk of mortality than patients who did not have HC (HR, 2.6; P = .018).
  
  
  CONCLUSIONS
  The above values were used to monitor plasma BKV-DNA load, and they provided a better prediction of patients at risk of HC than urine BKV-DNA load.
authors.affiliation: Pediatric Hematology Oncology, Azienda Ospedaliera Universitaria Integrata, Verona, Italy Pediatric Hematology Oncology, Department of Pediatrics.
authors.forename: Simone
authors.initials: S
authors.lastname: Cesaro
authors.affiliation: Pediatric Hematology Oncology, Azienda Ospedaliera Universitaria Integrata, Verona, Italy Pediatric Hematology Oncology, Department of Pediatrics.
authors.forename: Gloria
authors.initials: G
authors.lastname: Tridello
authors.affiliation: Pediatric Hematology Oncology, Department of Pediatrics.
authors.forename: Marta
authors.initials: M
authors.lastname: Pillon
authors.affiliation: Pediatric Hematology Oncology, Department of Pediatrics.
authors.forename: Elisabetta
authors.initials: E
authors.lastname: Calore
authors.affiliation: Department of Molecular Medicine, University of Padova, Italy.
authors.forename: Davide
authors.initials: D
authors.lastname: Abate
authors.affiliation: Pediatric Hematology Oncology, Department of Pediatrics.
authors.forename: Manuela
authors.initials: M
authors.lastname: Tumino
authors.affiliation: Pediatric Hematology Oncology, Department of Pediatrics.
authors.forename: Nicolina
authors.initials: N
authors.lastname: Carucci
authors.affiliation: Pediatric Hematology Oncology, Department of Pediatrics.
authors.forename: Stefania
authors.initials: S
authors.lastname: Varotto
authors.affiliation: Pediatric Hematology Oncology, Azienda Ospedaliera Universitaria Integrata, Verona, Italy.
authors.forename: Elisa
authors.initials: E
authors.lastname: Cannata
authors.affiliation: Pediatric Hematology Oncology, Azienda Ospedaliera Universitaria Integrata, Verona, Italy.
authors.forename: Anna
authors.initials: A
authors.lastname: Pegoraro
authors.affiliation: Department of Molecular Medicine, University of Padova, Italy.
authors.forename: Luisa
authors.initials: L
authors.lastname: Barzon
authors.affiliation: Department of Molecular Medicine, University of Padova, Italy.
authors.forename: Giorgio
authors.initials: G
authors.lastname: Palù
authors.affiliation: Pediatric Hematology Oncology, Department of Pediatrics.
authors.forename: Chiara
authors.initials: C
authors.lastname: Messina
mesh_terms: D015746:Abdominal Pain / Q000209:etiology; D000293:Adolescent; D001739:BK Virus / Q000502:physiology; D002648:Child; D002675:Child, Preschool; D003556:Cystitis / Q000209:etiology* / Q000401:mortality; D005260:Female; D018380:Hematopoietic Stem Cell Transplantation / Q000009:adverse effects* / Q000706:statistics & numerical data; D006470:Hemorrhage / Q000209:etiology* / Q000401:mortality; D006801:Humans; D015994:Incidence; D007223:Infant; D008297:Male; D027601:Polyomavirus Infections / Q000097:blood* / Q000150:complications* / Q000652:urine*; D011237:Predictive Value of Tests; D011446:Prospective Studies; D012307:Risk Factors; D012680:Sensitivity and Specificity; D014412:Tumor Virus Infections / Q000097:blood* / Q000150:complications* / Q000652:urine*; D014555:Urination Disorders / Q000209:etiology; D019562:Viral Load / Q000706:statistics & numerical data*; D014766:Viremia / Q000150:complications
keywords: BK virus; hematopoietic stem cell transplantation; hemorrhagic cystitis; pediatric