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Polyoma BK viruria in patients undergoing autologous hematopoietic stem cell transplantation

Bone Marrow Transplantation volume 35, pages 1029–1030 (2005)Cite this article

Hemorrhagic cystitis (HC) is an important complication after hematopoietic stem cell transplantation (HSCT).1 The severity varies from microscopic hematuria to severe hemorrhage leading to clot retention and urinary tract obstruction. Based on the temporal relationship to HSC engraftment, HC can be divided into pre- and post-engraftment subtypes.2 Pre-engraftment HC is related to urothelial toxicity induced by chemo-irradiation during conditioning. It is usually transient, with an incidence similar in both autologous and allogeneic HSCT.2 On the contrary, post-engraftment HC is a major complication and a common cause of prolonged hospitalization after allogeneic HSCT.

The pathogenesis of post-engraftment HC is not well defined. Reactivation of human polyoma BK virus (BKV) leading to BK viruria is a distinct risk factor.2, 3 We have demonstrated that post-engraftment HC is invariably preceded by a peaking in BK viruria.3 However, not all patients with BKV reactivation develop HC, suggesting that additional pathogenetic factors are involved. Furthermore, most cases of post-engraftment HC have been found in allogeneic HSCT, in the presence of graft-versus-host diseases (GVHD).1, 2, 4 To segregate the impacts of BKV reactivation and allo-immunity on post-engraftment HC, we studied a cohort of patients after autologous HSCT, where allo-immunity would not be a confounding factor.

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Authors and Affiliations

  1. Department of Medicine, Professorial Block, Queen Mary Hospital, Pokfulam Road, Hong Kong

    A Y H Leung, M Chan, A K W Lie & Y-L Kwong

  2. Department of Microbiology, University of Hong Kong, Hong Kong

    V C C Cheng & K-Y Yuen

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  1. A Y H Leung
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  2. M Chan
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  3. V C C Cheng
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  4. A K W Lie
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  5. K-Y Yuen
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  6. Y-L Kwong
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Leung, A., Chan, M., Cheng, V. et al. Polyoma BK viruria in patients undergoing autologous hematopoietic stem cell transplantation. Bone Marrow Transplant 35, 1029–1030 (2005). https://doi.org/10.1038/sj.bmt.1704944

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