1. ¹Department of Oncology-Pathology, Karolinska Institutet, Stockholm, Sweden
2. ²Department of Paediatrics, Karolinska University Hospital and Karolinska Institutet, Stockholm, Sweden
3. ³Department of Clinical Microbiology, Karolinska University Hospital and Karolinska Institutet, Stockholm, Sweden
4. ⁴Department of Clinical Immunology, Karolinska University Hospital and Karolinska Institutet, Stockholm, Sweden
5. ⁵Johns Hopkins University School of Medicine, Baltimore, MD, USA
6. ⁶Centre for Allogeneic Stem Cell Transplantation, Karolinska University Hospital and Karolinska Institutet, Stockholm, Sweden
7. ⁷Haematology Centre, Karolinska University Hospital and Karolinska Institutet, Stockholm, Sweden
8. ⁸Swedish Institute for Infectious Disease Control, Solna, Sweden

Correspondence: Dr T Dalianis, Department of Oncology-Pathology, Karolinska Institutet, Karolinska University Hospital CCK, R8:01, Stockholm 171 76, Sweden. E-mail: tina.dalianis@ki.se

Received 1 August 2007; Revised 6 November 2007; Accepted 9 November 2007; Published online 7 January 2008.

Abstract

The influence of conditioning regimen, donor background and HLA matching on development of BK virus (BKV)-associated haemorrhagic cystitis (HC) was examined in 175 allogeneic haematopoietic stem cell transplant (HSCT) patients, undergoing 179 HSCT events. Twenty-seven patients presented late-onset HC, and BK viruria was verified in 23/27 HC events. Seventy-one (40% ) HSCTs were performed with myeloablative conditioning (MC), 108 (60% ) were performed with reduced intensity conditioning (RIC), 66 (37% ) were performed with a related donor (RD) grafts and 113 (63% ) with an unrelated donor (URD) graft. BK viruria was more common during HC, than non-HC events, after MC as compared to RIC (both P<0.001), and with an HLA-mismatched donor (P<0.01). By multivariate logistical regression analysis, independent risk factors for HC were BKV (OR 6.7; 95% CI 2.0–21.7; P=0.001), MC (OR 6.0; 95% CI 2.1–17.3; P<0.001) and URD (OR 3.4; 95% CI 1.1–10.6; P=0.03). However, when analysing HSCT performed with URD or RD grafts separately, BKV (OR 8.5; 95% CI 1.8–19.3; P=0.004) and MC (OR 5.9; 95% CI 1.3–11.3; P=0.009) increased the risk for HC only with a URD, but not with an RD graft.