Abstract
Late-onset hemorrhagic cystitis (HC) after allogeneic hematopoietic stem cell transplantation (HSCT) has been associated with BK virus (BKV). Antiviral drugs are of limited efficacy and the optimal treatment for HC has not yet been established. Hyperbaric oxygen (HBO) may benefit these patients. We, therefore, retrospectively evaluated the effectiveness of HBO therapy in 16 patients with HC after allogeneic HSCT. All 16 patients had macroscopic hematuria and BKV infection. Patients received 100% oxygen in a hyperbaric chamber at 2.1 atmospheres for 90 min, 5 days per week, with a median 13 treatments (range, 4–84). Fifteen patients (94%) showed complete resolution of hematuria. Median urinary DNA BKV titers declined after HBO (P<0.05). Patients started on HBO earlier after diagnosis of HC responded sooner (P<0.05). HBO was generally well tolerated and proved to be a reliable option for this difficult to manage condition.
This is a preview of subscription content, access via your institution
Access options
Subscribe to this journal
Receive 12 print issues and online access
$259.00 per year
only $21.58 per issue
Buy this article
- Purchase on Springer Link
- Instant access to full article PDF
Prices may be subject to local taxes which are calculated during checkout
Similar content being viewed by others
References
Seber A, Shu XO, Defor T, Sencer S, Ramsay N . Risk factors for severe hemorrhagic cystitis following BMT. Bone Marrow Transplant 1999; 23: 35–40.
deVries CR, Freiha FS . Hemorrhagic cystitis: a review. J Urol 1990; 143: 1–9.
Khojasteh NH, Zakerinia M, Ramzi M, Haghshenas M . A new regimen of MESNA (2-mercaptoethanesulfonate) effectively prevents cyclophosphamide-induced hemorrhagic cystitis in bone marrow transplant recipients. Transplant Proc 2000; 32: 596.
Tsuboi K, Kishi K, Ohmachi K, Yasuda Y, Shimizu T, Inoue H et al. Multivariate analysis of risk factors for hemorrhagic cystitis after hematopoietic stem cell transplantation. Bone Marrow Transplant 2003; 32: 903–907.
Decker DB, Karam JA, Wilcox DT . Pediatric hemorrhagic cystitis. J Pediatr Urol 2009; 5: 254–264.
Laszlo D, Bosi A, Guidi S, Saccardi R, Vannucchi AM, Lombardini L et al. Prostaglandin E2 bladder instillation for the treatment of hemorrhagic cystitis after allogeneic bone marrow transplantation. Haematologica 1995; 80: 421–425.
Dorticos E, Pavon V, Jaime JC, Reboredo M, Lopez Saura P, Berlanga J et al. Successful application of epidermal growth factor for treatment of hemorrhagic cystitis after bone marrow transplantation. Bone Marrow Transplant 2003; 31: 615–616.
Vela-Ojeda J, Tripp-Villanueva F, Sanchez-Cortes E, Ayala-Sanchez M, Garcia-Ruiz Esparza MA, Rosas-Cabral A et al. Intravesical rhGM-CSF for the treatment of late onset hemorrhagic cystitis after bone marrow transplant. Bone Marrow Transplant 1999; 24: 1307–1310.
Gine E, Rovira M, Real I, Burrel M, Montana J, Carreras E et al. Successful treatment of severe hemorrhagic cystitis after hemopoietic cell transplantation by selective embolization of the vesical arteries. Bone Marrow Transplant 2003; 31: 923–925.
Cesaro S, Brugiolo A, Faraci M, Uderzo C, Rondelli R, Favre C et al. Incidence and treatment of hemorrhagic cystitis in children given hematopoietic stem cell transplantation: a survey from the Italian association of pediatric hematology oncology-bone marrow transplantation group. Bone Marrow Transplant 2003; 32: 925–931.
Etlik O, Tomur A, Deveci S, Piskin I, Pekcan M . Comparison of the uroprotective efficacy of mesna and HBO treatments in cyclophosphamide-induced hemorrhagic cystitis. J Urol 1997; 158: 2296–2299.
Kalayoglu-Besisik S, Abdul-Rahman IS, Erer B, Yenerel MN, Oguz FS, Tunc M et al. Outcome after hyperbaric oxygen treatment for cyclophosphamide-induced refractory hemorrhagic cystitis. J Urol 2003; 170: 922.
Furness 3rd PD, Palmer LS, Palmer JS, Capelli-Schellpfeffer M, Cheng EY . Hyperbaric oxygen therapy for pediatric hemorrhagic cystitis. J Urol 1999; 161: 1596–1597.
Focosi D, Maggi F, Pistolesi D, Benedetti E, Papineschi F, Galimberti S et al. Hyperbaric oxygen therapy in BKV-associated hemorrhagic cystitis refractory to intravenous and intravesical cidofovir: case report and review of literature. Leuk Res 2009; 33: 556–560.
Bratsas KS, Stephanides AA, Spyropoulos E, Zachariades BP, Androulakakis PA . Hyperbaric oxygen therapy for cyclophosphamide induced refractory hemorrhagic cystitis in a child. J Urol 2004; 172: 679.
Saito S, Kaiho Y, Namina T, Konda R, Satoh M, Ishidoya S et al. A case of severe hemorrhagic cystitis following bone marrow transplantation. Int Urol Nephrol 2004; 36: 349–352.
Yoshida T, Kawashima A, Ujike T, Uemura M, Nishimura K, Miyoshi S . Hyperbaric oxygen therapy for radiation-induced hemorrhagic cystitis. Int J Urol 2008; 15: 639–641.
Corman JM, McClure D, Pritchett R, Kozlowski P, Hampson NB . Treatment of radiation induced hemorrhagic cystitis with hyperbaric oxygen. J Urol 2003; 169: 2200–2202.
Chong KT, Hampson NB, Corman JM . Early hyperbaric oxygen therapy improves outcome for radiation-induced hemorrhagic cystitis. Urology 2005; 65: 649–653.
Tibbles PM, Edelsberg JS . Hyperbaric-oxygen therapy. N Engl J Med 1996; 334: 1642–1648.
El-Zimaity M, Saliba R, Chan K, Shahjahan M, Carrasco A, Khorshid O et al. Hemorrhagic cystitis after allogeneic hematopoietic stem cell transplantation: donor type matters. Blood 2004; 103: 4674–4680.
National Cancer Institute (NCI). Common Terminology Criteria for Adverse Events v4.0. US Department of Health and Human Services, National Institutes of Health, NCI, 2009.
Rodrigues C, Pinto D, Medeiros R . Molecular epidemiology characterization of the urinary excretion of polyomavirus in healthy individuals from Portugal--a Southern European population. J Med Virol 2007; 79: 1194–1198.
Miodosky M, Abdul-Hai A, Tsirigotis P, Or R, Bitan M, Resnick IB et al. Treatment of post-hematopoietic stem cell transplantation hemorrhagic cystitis with intravesicular sodium hyaluronate. Bone Marrow Transplant 2006; 38: 507–511.
Brugieres L, Hartmann O, Travagli JP, Benhamou E, Pico JL, Valteau D et al. Hemorrhagic cystitis following high-dose chemotherapy and bone marrow transplantation in children with malignancies: incidence, clinical course, and outcome. J Clin Oncol 1989; 7: 194–199.
Haines HL, Laskin BL, Goebel J, Davies SM, Yin HJ, Lawrence J et al. Blood, and not urine, BK viral load predicts renal outcome in children with hemorrhagic cystitis following hematopoietic stem cell transplantation. Biol Blood Marrow Transplant 2011; 17: 1512–1519.
Erard V, Kim HW, Corey L, Limaye A, Huang ML, Myerson D et al. BK DNA viral load in plasma: evidence for an association with hemorrhagic cystitis in allogeneic hematopoietic cell transplant recipients. Blood 2005; 106: 1130–1132.
Gaziev J, Paba P, Miano R, Germani S, Sodani P, Bove P et al. Late-onset hemorrhagic cystitis in children after hematopoietic stem cell transplantation for thalassemia and sickle cell anemia: a prospective evaluation of polyoma (BK) virus infection and treatment with cidofovir. Biol Blood Marrow Transplant 2010; 16: 662–671.
Leach RM, Rees PJ, Wilmshurst P . Hyperbaric oxygen therapy. BMJ 1998; 317: 1140–1143.
Yildiz S, Aktas S, Cimsit M, Ay H, Togrol E . Seizure incidence in 80 000 patient treatments with hyperbaric oxygen. Aviat Space Environ Med 2004; 75: 992–994.
Al-Seraihi A, Ayas M . Hyperbaric oxygen should not be used in the management of hemorrhagic cystitis in patients with Fanconi anemia. Pediatr Blood Cancer 2007; 49: 854–856.
Author information
Authors and Affiliations
Corresponding author
Ethics declarations
Competing interests
The authors declare no conflict of interest.
Rights and permissions
About this article
Cite this article
Savva-Bordalo, J., Pinho Vaz, C., Sousa, M. et al. Clinical effectiveness of hyperbaric oxygen therapy for BK-virus-associated hemorrhagic cystitis after allogeneic bone marrow transplantation. Bone Marrow Transplant 47, 1095–1098 (2012). https://doi.org/10.1038/bmt.2011.228
Received:
Revised:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1038/bmt.2011.228
Keywords
This article is cited by
-
Effectiveness of hyperbaric oxygen therapy for virus-associated hemorrhagic cystitis after allogeneic hematopoietic stem cell transplantation
International Journal of Hematology (2021)
-
Donor lymphocyte infusion for BK virus hemorrhagic cystitis and nephropathy: a case report
Bone Marrow Transplantation (2019)
-
The use of hyperbaric oxygen therapy in the treatment of hemorrhagic cystitis after allogeneic stem cell transplantation from an unrelated donor
International Journal of Hematology (2015)
-
Current Strategies for Prevention and Management of Stem Cell Transplant-Related Urinary Tract and Voiding Dysfunction
Current Bladder Dysfunction Reports (2015)
-
The apoptosis of peripheral blood lymphocytes promoted by hyperbaric oxygen treatment contributes to attenuate the severity of early stage acute pancreatitis in rats
Apoptosis (2014)