¹Children's Cancer Centre, Royal Children's Hospital, Parkville, Australia

Correspondence: Dr JA Heath, Children's Cancer Centre, Royal Children's Hospital, Flemington Road, Parkville, Melbourne, Victoria 3052, Australia. E-mail: john.heath@rch.org.au

Received 27 July 2005; Revised 16 November 2005; Accepted 25 November 2005; Published online 23 January 2006.

Abstract

Hemorrhagic cystitis (HC) after allogeneic hematopoietic stem cell transplantation (HSCT) can cause significant morbidity and mortality. Previous reports have suggested a role for estrogen in the control of HC in adult patients. Here, we describe the clinical courses of 10 children and adolescents treated with estrogen for HC following HSCT. Eight patients (80%) experienced a significant improvement in their hematuria following the commencement of therapy, with six (60%) undergoing resolution of macroscopic hematuria, without any recurrences. The treatment was well tolerated by the majority of patients, with only one patient needing to interrupt treatment (hepatotoxicity). We conclude that estrogen is well tolerated and often effective, and should be considered as an adjunctive treatment option in children and adolescents with HC following HSCT.