Abstract
Hemorrhagic cystitis (HC) is a well-known complication of HSCT. Its overall incidence has been reported to vary from 7–68%. The spectrum of clinical presentation varies from asymptomatic microhematuria to life-threatening bleeding. Sodium hyaluronate is a glycosaminoglycan present on the bladder mucosa, which serves as an important protective substance against uroepithelial damage. Preparations of this component have been shown to be effective in the treatment of interstitial cystitis. We report our experience in the treatment of post-transplant HC with intravesical instillation of sodium hyaluronate. Five out of the seven patients included in this study achieved complete response, while one patient had only partial response. Sodium hyaluronate administration was not associated with any local or systemic adverse effects. We consider that the results of our study are promising and the efficacy of sodium hyaluronate in the treatment of post-transplant HC should be tested in larger cohorts of patients.
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References
El-Zimaity M, Saliba R, Chan K, Shahjahan M, Carrasco A, Khorshid O et al. Hemorrhagic cystitis after hematopoietic stem cell transplantation: donor type matters. Blood 2004; 103: 4674–4679.
Cesaro S, Brugiolo A, Faraci M, Uderzo C, Rondelli R, Favre C et al. Incidence and treatment of hemorrhagic cystitis in children given hematopoietic stem cell transplantation: a survey from the Italian association of pediatric hematology oncology – bone marrow transplantation group. Bone Marrow Transplant 2003; 32: 925–931.
Hale GA, Rochester RJ, Heslop HE, Krance RA, Gingrich JR, Benaim E et al. Hemorrhagic cystitis after allogeneic bone marrow transplantation in children: clinical characteristics and outcome. Biol Blood Marrow Transplant 2003; 9: 698–705.
Leung AYH, Yue KY, Kwong YL . Polyoma BK virus and hemorrhagic cystitis in hematopoietic stem cell transplantation: a changing paradigm. Bone Marrow Transplant 2005; 36: 929–937.
Tsuboi K, Kishi K, Ohmachi K, Yasuda Y, Shimizu T, Inoue H et al. Multivariate analysis of risk factors for hemorrhagic cystitis after hematopoietic stem cell transplantation. Bone Marrow Transplant 2003; 32: 903–907.
Morales A, Emerson L, Nickel JC, Lundie M . Intravesical hyaluronic acid in the treatment of refractory interstitial cystitis. J Urol 1996; 156: 45–48.
Kallestrup EB, Jorgensen SS, Nordling J, Hald T . Treatment of interstitial cystitis with Cystistat: a hyaluronic acid product. Scand J Urol Nephrol 2005; 39: 143–147.
Diamantopoulos J, Kapsalis Z, Pliotas G, Koliarakis N, Antonadou T, Karagiorgis P . Use of sodium hyaluronate solution in patients suffering from post-radiation cystitis. Radiother Oncol 2004; 7 (Suppl 1): S461.
Brugeries L, Hartmann O, Travagli JP, Benhamou E, Pico JL, Valteau D et al. Hemorrhagic cystitis following high dose chemotherapy and bone marrow transplantation in children with malignancies: incidence, clinical course, and outcome. J Clin Oncol 1989; 7: 194–197.
Seber A, Shu XO, Defor T, Sencer S, Ramsay N . Risk factors for severe hemorraghic cystitis following BMT. Bone Marrow Transplant 1999; 23: 35–40.
Asano Y, Kanda Y, Ogana N, Sakata-Yanagimoto M, Nakagawa M, Kawazu M et al. Male predominance among Japanese adult patients with late-onset hemorrhagic cystitis after hematopoietic stem cell transplantation. Bone Marrow Transplant 2003; 32: 1175–1179.
de Vries CR, Freiha FS . Hemorrhagic cystitis: a review. J Urol 1990; 143: 1–9.
Akiyama H, Kurosu T, Sakashita C, Inoue T, Mori SI, Ohashi K et al. Adenovirus is a key pathogen in hemorrhagic cystitis associated with bone marrow transplantation. Clin Infect Dis 2001; 32: 1325–1330.
Azzi A, Cesaro S, Laszlo D, Zakrzewska K, Ciappi S, De Santis R et al. Human polyomavirus BK (BKV) load and hemorrhagic cystitis in bone marrow transplantation patients. J Clin Virol 1999; 14: 79–86.
Choong SK, Walkden M, Kirby R . The management of intractable haematuria. Brit J Urol 2000; 86: 951–959.
Kennedy C, Snell ME, Witherow RO . Use of alum to control intractable vesical hemorrhage. Brit J Urol 1984; 56: 673–675.
Kavoussi LR, Gelstein LD, Andriole GL . Encephalopathy and an elevated serum aluminium level in a patient receiving intravesical alum irrigation for severe urinary hemorrhage. J Urol 1986; 136: 665–667.
Kumar S, Rosen P, Grabstald H . Intravesical formalin for the control of intractable bladder hemorrhage secondary to cystitis or cancer. J Urol 1975; 114: 540–543.
Fair WR . Formalin in the treatment of massive bladder hemorrhage. Techniques, results and complications. Urology 1974; 3: 573–576.
Trigg ME, O'Reilly J, Rumelhart S, Morgan D, Holida M, de Alarcon P . Prostaglandin E1 bladder instillations to control severe hemorrhagic cystitis. J Urol 1990; 143: 92–94.
Levine LA, Jarrard DF . Treatment of cyclophosphamide induced hemorrhagic cystitis with intravesical carboprost tromethamine. J Urol 1993; 149: 719–723.
Ippoliti C, Przepiorka D, Mehra R, Neumann J, Wood J, Claxton D et al. Intravesicular carboprost for the treatment of hemorrhagic cystitis after marrow transplantation. Urology 1995; 46: 811–815.
Nagafuji K, Aoki K, Henzan H, Kato K, Miyamoto T, Eto T et al. Cidofovir for treating adenoviral haemorrhagic cystitis in hematopoietic stem cell transplant recipients. Bone Marrow Transplant 2004; 34: 909–914.
Fanourgiakis P, Georgala A, Vekemans M, Triffet A, De Bruyn JM, Duchateau V et al. Intravesical instillation of cidofovir in the treatment of hemorrhagic cystitis caused by adenovirus type 11 in a bone marrow transplant recipient. Clin Infect Dis 2005; 40: 199–201.
Hattori K, Yabe M, Matsumoto M, Kudo Y, Yasuda Y, Inoue H et al. Successful hyperbaric oxygen treatment of life-threatening hemorrhagic cystitis after allogeneic bone marrow transplantation. Bone Marrow Transplant 2001; 27: 1315–1317.
Garderet L, Bittencourt H, Sebe P, Kaliski A, Claisse JP, Esperou H et al. Cystectomy for severe hemorrhagic cystitis in allogeneic stem cell transplant recipients. Transplantation 2000; 70: 1807–1811.
Gine E, Rovira M, Real I, Burrel M, Montana J, Carreras E et al. Successful treatment of severe hemorrhagic cystitis after hematopoietic cell transplantation by selective embolization of the vesical arteries. Bone Marrow Transplant 2003; 31: 923–925.
Paladri F, Bonifazi F, Rossi C, Falcioni S, Arpinati M, Giannini MB et al. Successful treatment of severe haemorrhagic cystitis with selective vesical artery embolization. Bone Marrow Transplant 2005; 35: 529–530.
Hurst RE, Rhodes SW, Adamson PB, Parsons CL, Roy JB . Functional and structural characteristics if the glycosaminoglycans of the bladder luminal surface. J Urol 1987; 138: 433–437.
Parsons CL . The therapeutic role of sulfated polysaccharides in urinary bladder. Urol Clin North Am 1994; 21: 93–100.
Goldberg RL, Tole BP . Hyaluronate inhibition of cell proliferation. Arthritis Rheum 1987; 30: 769–778.
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Miodosky, M., Abdul-Hai, A., Tsirigotis, P. et al. Treatment of post-hematopoietic stem cell transplantation hemorrhagic cystitis with intravesicular sodium hyaluronate. Bone Marrow Transplant 38, 507–511 (2006). https://doi.org/10.1038/sj.bmt.1705474
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DOI: https://doi.org/10.1038/sj.bmt.1705474
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