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Post-Transplant Events

Low-dose cidofovir treatment of BK virus-associated hemorrhagic cystitis in recipients of hematopoietic stem cell transplant

Bone Marrow Transplantation volume 39, pages 783–787 (2007)Cite this article

Abstract

In recipients of hematopoietic stem cell transplants (HSCTs), BK virus (BKV) has been associated with late-onset hemorrhagic cystitis (HC). In our institution, HSCT recipients with BKV-associated HC are treated with 1 mg/kg of cidofovir weekly. We identified HSCT recipients with BKV-associated HC, treated with weekly cidofovir. Microbiological response was defined as at least a one log reduction in urinary BKV viral load; clinical response was defined as improvement in symptoms and stability or reduction in the grade of cystitis. Nineteen allogeneic HSCT patients received a mean of 4.5 weekly doses of cidofovir. HC occurred at a mean of 68.7 days after transplant. A clinical response was detected in 16/19 (84%) patients, and 9/19 (47%) had a measurable microbiological response (8/10 nonresponders had a BKV viral load above the upper limit of the assay before treatment). Fourteen out of nineteen (74%) patients had no significant increase in serum creatinine. Five patients with renal dysfunction resolved after completion of the therapy and removal of other nephrotoxic agents. We conclude that weekly low-dose cidofovir appears to be a safe treatment option for BKV-associated HC. Although the efficacy of low-dose cidofovir is not proven, a prospective trial is warranted.

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Authors and Affiliations

  1. Division of Hematology–Oncology, Department of Internal Medicine, University of Michigan Medical School, Ann Arbor, MI, USA

    M R Savona

  2. Department of Pathology, University of Michigan Medical School, Ann Arbor, MI, USA

    D Newton

  3. College of Pharmacy, Ann Arbor, MI, USA

    D Frame

  4. Division of Hemato–Oncology, Department of Pediatrics, Blood and Bone Marrow Transplant Program, University of Michigan Medical School, Ann Arbor, MI, USA

    J E Levine & S Mineishi

  5. Division of Infectious Diseases, Department of Internal Medicine, University of Michigan Medical School, Ann Arbor, MI, USA

    D R Kaul

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  1. M R Savona
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  2. D Newton
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  4. J E Levine
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  5. S Mineishi
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Correspondence to D R Kaul.

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Savona, M., Newton, D., Frame, D. et al. Low-dose cidofovir treatment of BK virus-associated hemorrhagic cystitis in recipients of hematopoietic stem cell transplant. Bone Marrow Transplant 39, 783–787 (2007). https://doi.org/10.1038/sj.bmt.1705678

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