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Post-Transplant Events

Cidofovir for treating adenoviral hemorrhagic cystitis in hematopoietic stem cell transplant recipients

Bone Marrow Transplantation volume 34, pages 909–914 (2004)Cite this article

Summary:

Adenovirus (AdV) infection is an important cause of morbidity and mortality in hematopoietic stem cell transplant (HSCT) recipients. We treated 16 patients with AdV hemorrhagic cystitis (HC) following HSCT with cidofovir (CDV; 1 mg/kg/day, three times weekly for 3 weeks). Patients included 10 males and six females with a median age of 50 years (range 10–62). Two of the 16 patients were unevaluable because of early death from nonadenoviral causes. CDV therapy cleared AdV from urine in 12 of 14 patients (86%). Of 14 patients, 10 (71%) showed clinical improvements in HC. Among 14 patients, seven (50%) had avoided renal damage, the most important CDV toxicity. One patient previously treated with foscarnet for cytomegalovirus (CMV) required hemodialysis, and CDV treatment was discontinued. In another patient, CDV treatment was discontinued because of grade 2 nephrotoxicity. Four patients became positive for CMV antigenemia while being treated with CDV, and two developed herpes simplex virus (HSV) stomatitis while being treated with CDV. CDV proved effective in treating AdV HC in transplant patients. However, CDV at 1 mg/kg/day given three times weekly failed to prevent breakthrough infection with CMV and HSV in some patients.

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References

  1. Ambinder RF, Burns W, Forman M et al. Hemorrhagic cystitis associated with adenovirus infection in bone marrow transplantation. Arch Intern Med 1986; 146: 1400–1401.

    Article  CAS  PubMed  Google Scholar 

  2. Miyamura K, Takeyama K, Kojima S et al. Hemorrhagic cystitis associated with urinary excretion of adenovirus type 11 following allogeneic bone marrow transplantation. Bone Marrow Transplant 1989; 4: 533–535.

    CAS  PubMed  Google Scholar 

  3. Londergan TA, Walzak MP . Hemorrhagic cystitis due to adenovirus infection following bone marrow transplantation. J Urol 1994; 151: 1013–1014.

    Article  CAS  PubMed  Google Scholar 

  4. Bruno B, Gooley T, Hackman RC et al. Adenovirus infection in hematopoietic stem cell transplantation: effect of ganciclovir and impact on survival. Biol Blood Marrow Transplant 2003; 9: 341–352.

    Article  PubMed  Google Scholar 

  5. Shields AF, Hackman RC, Fife KH et al. Adenovirus infections in patients undergoing bone-marrow transplantation. N Engl J Med 1985; 312: 529–533.

    Article  CAS  PubMed  Google Scholar 

  6. Flomenberg P, Babbitt J, Drobyski WR et al. Increasing incidence of adenovirus disease in bone marrow transplant recipients. J Infect Dis 1994; 169: 775–781.

    Article  CAS  PubMed  Google Scholar 

  7. La Rosa AM, Champlin RE, Mirza N et al. Adenovirus infections in adult recipients of blood and marrow transplants. Clin Infect Dis 2001; 32: 871–876.

    Article  CAS  PubMed  Google Scholar 

  8. Chakrabarti S, Mautner V, Osman H et al. Adenovirus infections following allogeneic stem cell transplantation: incidence and outcome in relation to graft manipulation, immunosuppression, and immune recovery. Blood 2002; 100: 1619–1627.

    Article  CAS  PubMed  Google Scholar 

  9. Childs R, Sanchez C, Engler H et al. High incidence of adeno- and polyomavirus-induced hemorrhagic cystitis in bone marrow allotransplantation for hematological malignancy following T cell depletion and cyclosporine. Bone Marrow Transplant 1998; 22: 889–893.

    Article  CAS  PubMed  Google Scholar 

  10. Hale GA, Heslop HE, Krance RA et al. Adenovirus infection after pediatric bone marrow transplantation. Bone Marrow Transplant 1999; 23: 277–282.

    Article  CAS  PubMed  Google Scholar 

  11. Howard DS, Phillips IG, Reece DE et al. Adenovirus infections in hematopoietic stem cell transplant recipients. Clin Infect Dis 1999; 29: 1494–1501.

    Article  CAS  PubMed  Google Scholar 

  12. Hromas R, Cornetta K, Srour E et al. Donor leukocyte infusion as therapy of life-threatening adenoviral infections after T-cell-depleted bone marrow transplantation. Blood 1994; 84: 1689–1690.

    CAS  PubMed  Google Scholar 

  13. Chen FE, Liang RH, Lo JY et al. Treatment of adenovirus-associated haemorrhagic cystitis with ganciclovir. Bone Marrow Transplant 1997; 20: 997–999.

    Article  CAS  PubMed  Google Scholar 

  14. Kitabayashi A, Hirokawa M, Kuroki J et al. Successful vidarabine therapy for adenovirus type 11-associated acute hemorrhagic cystitis after allogeneic bone marrow transplantation. Bone Marrow Transplant 1994; 14: 853–854.

    CAS  PubMed  Google Scholar 

  15. Cassano WF . Intravenous ribavirin therapy for adenovirus cystitis after allogeneic bone marrow transplantation. Bone Marrow Transplant 1991; 7: 247–248.

    CAS  PubMed  Google Scholar 

  16. Liles WC, Cushing H, Holt S et al. Severe adenoviral nephritis following bone marrow transplantation: successful treatment with intravenous ribavirin. Bone Marrow Transplant 1993; 12: 409–412.

    CAS  PubMed  Google Scholar 

  17. Bordigoni P, Carret AS, Venard V et al. Treatment of adenovirus infections in patients undergoing allogeneic hematopoietic stem cell transplantation. Clin Infect Dis 2001; 32: 1290–1297.

    Article  CAS  PubMed  Google Scholar 

  18. Safrin S, Cherrington J, Jaffe HS . Clinical uses of cidofovir. Rev Med Virol 1997; 7: 145–156.

    Article  CAS  PubMed  Google Scholar 

  19. Legrand F, Berrebi D, Houhou N et al. Early diagnosis of adenovirus infection and treatment with cidofovir after bone marrow transplantation in children. Bone Marrow Transplant 2001; 27: 621–626.

    Article  CAS  PubMed  Google Scholar 

  20. Hoffman JA, Shah AJ, Ross LA, Kapoor N . Adenoviral infections and a prospective trial of cidofovir in pediatric hematopoietic stem cell transplantation. Biol Blood Marrow Transplant 2001; 7: 388–394.

    Article  CAS  PubMed  Google Scholar 

  21. Asano Y, Kanda Y, Ogawa N 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.

    Article  CAS  PubMed  Google Scholar 

  22. Sencer SF, Haake RJ, Weisdorf DJ . Hemorrhagic cystitis after bone marrow transplantation. Risk factors and complications. Transplantation 1993; 56: 875–879.

    Article  CAS  PubMed  Google Scholar 

  23. Vistide (cidofovir injection). http://www.gilead.com/pdf/vistide.pdf

  24. Mori K, Yoshihara T, Nishimura Y et al. Acute renal failure due to adenovirus-associated obstructive uropathy and necrotizing tubulointerstitial nephritis in a bone marrow transplant recipient. Bone Marrow Transplant 2003; 31: 1173–1176.

    Article  CAS  PubMed  Google Scholar 

  25. Ljungman P, Ribaud P, Eyrich M et al. Cidofovir for adenovirus infections after allogeneic hematopoietic stem cell transplantation: a survey by the Infectious Diseases Working Party of the European Group for Blood and Marrow Transplantation. Bone Marrow Transplant 2003; 31: 481–486.

    Article  CAS  PubMed  Google Scholar 

  26. Ljungman P, Deliliers GL, Platzbecker U et al. Cidofovir for cytomegalovirus infection and disease in allogeneic stem cell transplant recipients. The Infectious Diseases Working Party of the European Group for Blood and Marrow Transplantation. Blood 2001; 97: 388–392.

    Article  CAS  PubMed  Google Scholar 

  27. Ljungman P . Prevention and treatment of viral infections in stem cell transplant recipients. Br J Haematol 2002; 118: 44–57.

    Article  CAS  PubMed  Google Scholar 

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Authors and Affiliations

  1. Medicine and Biosystemic Science, Kyushu University Graduate School of Medical Sciences, Fukuoka, Japan

    K Nagafuji, K Aoki, H Henzan, K Kato, T Miyamoto & M Harada

  2. Department of Hematology, Hamanomachi General Hospital, Fukuoka, Japan

    T Eto & H Gondo

  3. Section of Pediatrics, National Kyushu Cancer Center, Fukuoka, Japan

    Y Nagatoshi

  4. Department of Internal Medicine, Japanese Red Cross Nagoya First Hospital, Nagoya, Japan

    T Ohba

  5. Department of Hematology, Imamura Bun-in Hospital, Kagoshima, Japan

    K Obama

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  1. K Nagafuji
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  2. K Aoki
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  4. K Kato
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  5. T Miyamoto
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  6. T Eto
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  8. T Ohba
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  9. K Obama
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  10. H Gondo
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  11. M Harada
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Correspondence to K Nagafuji.

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Nagafuji, K., Aoki, K., Henzan, H. et al. Cidofovir for treating adenoviral hemorrhagic cystitis in hematopoietic stem cell transplant recipients. Bone Marrow Transplant 34, 909–914 (2004). https://doi.org/10.1038/sj.bmt.1704682

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  • DOI: https://doi.org/10.1038/sj.bmt.1704682

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