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BK-virus prophylaxis: still no answer

Bone Marrow Transplantation volume 48, pages 1362–1363 (2013)Cite this article

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Hemorrhagic cystitis (HC) occurring after engraftment in recipients of allogeneic hematopoietic stem cell transplants (HSCT) has been associated with latent BK-virus (BKV) reactivation. In 1986, Arthur et al.1 published a series of 53 patients showing that HC occurred four times more frequently in patients who excreted BKV than those who did not.

Now, 27 years later, we know that unrelated donor transplants, mismatched-grafts and myeloablative conditioning increase the risk of BKV-related HC2, 3 and we know of the severe morbidity and negative impact on transplant outcomes it can have. However, treatment remains inadequate and relies largely on supportive care and measures to control bleeding. To date, no antiviral drug with proven efficacy against BKV replication has been licensed. This underscores the need for effective prophylaxis in our HSCT patients.

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References

  1. Arthur R, Shah K, Baust S, Santos G, Saral R . 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 

  2. Giraud G, Bogdanovic G, Priftakis P, Remberger M, Svahn BM, Barkholt L et al. The incidence of hemorrhagic cystitis and BK-viruria in allogeneic hematopoietic stem cell recipients according to intensity of the conditioning regimen. Haematologica 2006; 91: 401–104.

    PubMed  Google Scholar 

  3. Giraud G, Priftakis P, Bogdanovic G, Remberger M, Dubrulle M, Hau A . BK-viruria and haemorrhagic cystitis are more frequent in allogeneic hematopoietic stem cell transplant patients receiving full conditioning and unrelated-HLA-mismatched grafts. Bone Marrow Transplant 2008; 41: 737–742.

    Article  CAS  PubMed  Google Scholar 

  4. Stenlund A . Initiation of DNA replication: lessons from viral initiator proteins. Nat Rev Mol Cell Biol 2003; 4: 777–785.

    Article  CAS  PubMed  Google Scholar 

  5. Leung A, Chan M, Yuen KY, Cheng V, Chan KH, Wong C et al. Ciprofloxacin decreased Polyoma BK virus load in patients who underwent allogeneic hematopoietic stem cell transplantation. Clin Infect Dis 2005; 40: 528–537.

    Article  CAS  PubMed  Google Scholar 

  6. Miller A, Glode A, Hogan K, Schaub C, Kramer C, Stuart R et al. Efficacy and safety of ciprofloxacin for prophylaxis of Polyomavirus BK virus-associated hemorrhagic cystitis in allogeneic hematopoietic stem cell transplantation recipients. Biol Blood Marrow Transplant 2011; 17: 1176–1181.

    Article  CAS  PubMed  Google Scholar 

  7. Bedi A, Miller C, Hanson J, Goodman S, Ambinder R, Charache P 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  PubMed  Google Scholar 

  8. Bacigalupo A, Ballen K, Rizzo D, Giralt S, Lazarus H, Ho V et al. Defining the intensity of conditioning regimens: working definitions. Biol Blood Marrow Transplant 2009; 15: 1628–1633.

    Article  PubMed  PubMed Central  Google Scholar 

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Authors and Affiliations

  1. Department of Haematology, Singapore General Hospital, Singapore, Singapore

    C Phipps, P Appan, Y Loh, M Koh, A Y L Ho, J J Lee, Y C Linn, Y T Goh & W Hwang

  2. Department of Pharmacy, Singapore General Hospital, Singapore, Singapore

    H Y Ng

  3. Department of Infectious Disease, Singapore General Hospital, Singapore, Singapore

    B H Tan

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  1. C Phipps
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  2. H Y Ng
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Correspondence to C Phipps.

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Phipps, C., Ng, H., Appan, P. et al. BK-virus prophylaxis: still no answer. Bone Marrow Transplant 48, 1362–1363 (2013). https://doi.org/10.1038/bmt.2013.62

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