1. ¹Department of Hematology, Jiangsu Institute of Hematology, The First Affiliated Hospital of Soochow University, Suzhou, PR China
2. ²Key Laboratory of Thrombosis and Haemostasis, Ministry of Health, Suzhou, PR China
3. ³Department of Interventional Radiology, The First Affiliated Hospital of Soochow University, Suzhou, PR China

Correspondence: Dr D Wu, Department of Hematology, Jiangsu Institute of Hematology, the First Affiliated Hospital of Soochow University, No. 188, ShiZi Street, Suzhou, Jiangsu 215006, PR China. E-mail: wudepei@medmail.com.cn

Received 20 August 2007; Revised 14 December 2007; Accepted 20 December 2007; Published online 4 February 2008.

Abstract

Hemorrhagic cystitis (HC) is a frequent and sometimes life-threatening complication after hematopoietic SCT (HSCT). Many therapeutic approaches have been performed to control HC, but their effect is still limited. The present study investigated the role of selective embolization of the internal iliac arteries in patients with severe HC after HSCT. Among 324 patients treated in our hospital by HSCT, 10 patients with late-onset HC were enrolled in this study. All the patients underwent allogeneic transplantation and CY for preconditioning, no improvement in routine management. A retrograde arterial catheterization of the femoral artery by modified Seldinger's technique was used to perform digital angiography of the aortoiliac sector. Selective embolization of the internal iliac arteries was then performed with gelatin sponge to confirm the occlusion of the vesical hypervascularization. Eight patients achieved complete response (CR), their hematuria and symptoms ceased after embolization treatment, including six from first treatment of embolization and two from second treatment. Two other patients obtained no response to embolization treatment. Our study showed that selective embolization of the internal iliac arteries is an effective treatment option in patients with severe HC after HSCT.