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Post-transplant Complications

Polyoma viruria following T-cell-depleted allogeneic transplants using Campath-1H: incidence and outcome in relation to graft manipulation, donor type and conditioning

Bone Marrow Transplantation volume 31, pages 379–386 (2003)Cite this article

Summary:

Haemorrhagic cystitis (HC) is an important cause of morbidity following stem cell transplantation (SCT) and has been associated with polyoma virus infection. We studied the incidence and outcome of polyoma virus infection in 58 T-cell-depleted SCT patients. T-cell depletion was carried out using Campath-1H, either 10 or 20 mg in vitro (n=33) or 50 or 100 mg in vivo (n=25) following conventional (n=35) or nonmyeloablative conditioning (n=23). A total of 21 patients (36%) had polyoma viruria at a median of 35 days (5–114); 30% among patients receiving Campath in vitro and 44% among those given in vivo. The only risk factor for polyoma viruria was graft-versus-host disease GVHD grade ⩾2. The onset of polyoma viruria coincided with Cytomegalovirus (CMV) reactivation in all six patients who reactivated both viruses. Prolonged viruria (defined as polyoma viruria >2 weeks) was documented in 10 patients (17%) and this was associated with GVHD ⩾grade 2. HC occurred in four patients. Prolonged viruria was associated with HC only in patients receiving unrelated donor grafts following conventional conditioning. HC was not observed following nonmyeloablative conditioning despite a higher incidence of prolonged viruria. Thus, HC was uncommon in patients with polyoma viruria following T-cell depletion with Campath, particularly after reduced intensity conditioning.

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References

  1. Shah KV . 1996 Polyomaviruses. In: Fields BN, Knipe DM, Howley PM (eds). Fields Virology, 3rd edn. Lippincott-Raven: Philadelphia.

    Google Scholar 

  2. Arthur RR, Shah KV, Baust SJ et al. Association of BK viruria with hemorrhagic cystitis in recipients of bone marrow transplants. N Eng J Med. 1986; 315: 230–234.

    Article  CAS  Google Scholar 

  3. Apperley JF, Rice SJ, Bishop JA et al. Late-onset hemorrhagic cystitis associated with urinary excretion of polyomaviruses after bone marrow transplantation. Transplantation 1987; 43: 108–112.

    Article  CAS  Google Scholar 

  4. Arthur RR, Shah KV, Charache P, Saral R . BK and JC virus infections in recipients of bone marrow transplants. J Infect Dis 1988; 158: 563–569.

    Article  CAS  Google Scholar 

  5. Chan PK, Ip KW, Shiu SY et al. Association between polyomaviruria and microscopic haematuria in bone marrow transplant recipients. J Infect 1994; 29: 139–146.

    Article  CAS  Google Scholar 

  6. Bedi A, Miller CB, Hanson JL et al. Association of BK virus with failure of prophylaxis against hemorrhagic cystitis following bone marrow transplantation. J Clin Oncol 1995; 13: 1103–1109.

    Article  CAS  Google Scholar 

  7. Peinemann F, de Villiers EM, Dorries K et al. Clinical course and treatment of haemorrhagic cystitis associated with BK type of human polyomavirus in nine paediatric recipients of allogeneic bone marrow transplants. Eur J Pediatr 2000; 159: 182–188.

    Article  CAS  Google Scholar 

  8. Azzi A, Cesaro S, Laszlo D et al. Human polyomavirus BK (BKV) load and haemorrhagic cystitis in bone marrow transplantation patients. J Clin Virol 1999; 14: 79–86.

    Article  CAS  Google Scholar 

  9. Russell SJ, Vowels MR, Vale T . Haemorrhagic cystitis in paediatric bone marrow transplant patients: an association with infective agents, GVHD and prior cyclophosphamide. Bone Marrow Transplant 1994; 13: 533–539.

    CAS  Google Scholar 

  10. Cottler-Fox M, Lynch M, Deeg HJ, Koss LG . Human polyomavirus: lack of relationship of viruria to prolonged or severe hemorrhagic cystitis after bone marrow transplant. Bone Marrow Transplant 1989; 4: 279–282.

    CAS  PubMed  Google Scholar 

  11. Azzi A, Fanci R, Bosi A et al. Monitoring of polyomavirus BK viruria in bone marrow transplantation patients by DNA hybridization assay and by polymerase chain reaction: an approach to assess the relationship between BK viruria and hemorrhagic cystitis. Bone Marrow Transplant 1994; 14: 235–240.

    CAS  PubMed  Google Scholar 

  12. Leung AY, Suen CK, Lie AK et al. Quantification of polyoma BK viruria in hemorrhagic cystitis complicating bone marrow transplantation. Blood 2001; 98: 1971–1978.

    Article  CAS  Google Scholar 

  13. 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  Google Scholar 

  14. Leung AY, Mak R, Lie AK et al. Clinicopathological features and risk factors of clinically overt haemorrhagic cystitis complicating bone marrow transplantation. Bone Marrow Transplant 2002; 29: 509–513.

    Article  CAS  Google Scholar 

  15. Rebello P, Cwynarski K, Varughese M et al. Pharmacokinetics of Campath-1H in BMT patients. Cytotherapy 2001; 3: 261–267.

    Article  CAS  Google Scholar 

  16. Klangsinsirikul P, Carter GI, Byrne JL et al. Campath-1G causes rapid depletion of circulating host dendritic cells (DCs) before allogeneic transplantation but does not delay donor DC reconstitution. Blood 2002; 99: 2586–2591.

    Article  CAS  Google Scholar 

  17. Bielorai B, Shulman LM, Rechavi G, Toren A . CMV reactivation induced BK virus-associated late onset haemorrhagic cystitis after peripheral blood stem cell transplantation. Bone Marrow Transplant 2001; 28: 613–614.

    Article  CAS  Google Scholar 

  18. Heibronn R, Albrecht I, Stephan S et al. Human cytomegalovirus induces JC virus DNA replication in human fibroblasts. Proc Natl Acad Sci USA 1993; 90: 11406–11410.

    Article  Google Scholar 

  19. Chapman C, Flower AJ, Durrant ST . The use of vidarabine in the treatment of human polyomavirus associated acute haemorrhagic cystitis. Bone Marrow Transplant 1991; 7: 481–483.

    CAS  PubMed  Google Scholar 

  20. Seabra C, Perez-Simon JA, Sierra M et al. Intra-muscular vidarabine therapy for polyomavirus-associated hemorrhagic cystitis following allogeneic hemopoietic stem cell transplantation. Bone Marrow Transplant 2000; 26: 1229–1230.

    Article  CAS  Google Scholar 

  21. Andrei G, Snoeck R, Vandeputte M, De Clercq E . Activities of various compounds against murine and primate polyomaviruses. Antimicrob Agents Chemother 1997; 41: 587–539.

    Article  CAS  Google Scholar 

  22. Held TK, Biel SS, Nitsche A et al. Treatment of BK virus-associated hemorrhagic cystitis and simultaneous CMV reactivation with prior cyclophosphamide. Bone Marrow Transplant 1994; 13: 533–539.

    Google Scholar 

  23. Gonzalez-Fraile MI, Canizo C, Caballero D et al. Cidofovir treatment of human polyomavirus-associated acute haemorrhagic cystitis. Transplant Infect Dis 2001; 3: 44–46.

    Article  CAS  Google Scholar 

  24. Chakrabarti S, Collingham KE, Fegan CD et al. Adenovirus infections following haematopoietic cell transplantation: is there a role for adoptive immunotherapy? Bone Marrow Transplant 2000; 26: 305–307.

    Article  CAS  Google Scholar 

  25. Drummond JE, Shah KV, Saral R et al. BK virus specific humoral and cell mediated immunity in allogeneic bone marrow transplant (BMT) recipients. J Med Virol 1987; 23: 331–344.

    Article  CAS  Google Scholar 

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Acknowledgements

We thank Professor G Hale, Professor H Waldmann and the staff of the Therapeutic Antibody Centre, University of Oxford for their contributions to the production of CAMPATH-1H antibody. Their work was supported by the United Kingdom Medical Research Council, Leukosite Inc and the EP Abraham's Trust.

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Authors and Affiliations

  1. Departments of Haematology, Birmingham Heartlands Hospital, Birmingham, UK

    S Chakrabarti & D W Milligan

  2. Public Health Laboratory Birmingham Heartlands Hospital, Birmingham, UK

    H Osman & K Collingham

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  1. S Chakrabarti
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  2. H Osman
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  3. K Collingham
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  4. D W Milligan
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Chakrabarti, S., Osman, H., Collingham, K. et al. Polyoma viruria following T-cell-depleted allogeneic transplants using Campath-1H: incidence and outcome in relation to graft manipulation, donor type and conditioning. Bone Marrow Transplant 31, 379–386 (2003). https://doi.org/10.1038/sj.bmt.1703847

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