膀胱内灌注卡介苗治疗肾移植患者的浅表性膀胱癌
Intravesical bacillus Calmette-Guèrin for the treatment of superficial bladder cancer in renal transplant patients.
作者信息
Palou Juan, Angerri Oriol, Segarra José, Caparrós Juan, Guirado Luis, Diaz Juan Manuel, Salvador-Bayarri José, Villavicencio-Mavrich Humberto
机构信息
Urology Department, Fundació Puigvert, Universidad Autónoma de Barcelona, Barcelona, Spain.
出版信息
Transplantation. 2003 Nov 27;76(10):1514-6. doi: 10.1097/01.TP.0000090748.32764.0F.
BACKGROUND
Intravesical instillations with bacillus Calmette-Guérin (BCG) is considered the treatment of choice in the prophylaxis of high-grade superficial bladder carcinoma and in the treatment of carcinoma in situ (CIS) of the bladder.
METHODS
There is no previous experience with BCG treatment in patients with renal transplantation. Theoretically, immunosuppression is a contraindication because of the risk of severe morbidity and sepsis. We present our experience with endovesical BCG in three renal transplant patients, under immunosuppressive treatment, with high-grade superficial bladder cancer and CIS.
RESULTS
Two patients are free of disease at 17 and 60 months. One patient developed disease recurrence and underwent a radical cystectomy. There was neither change in renal function nor any clinical evidence of tuberculous infection.
CONCLUSIONS
Intravesical BCG in superficial bladder cancer and/or CIS is a valid option, with no added morbidity to renal transplant patients.
背景
膀胱内灌注卡介苗（BCG）被认为是预防高级别浅表性膀胱癌和治疗膀胱原位癌（CIS）的首选治疗方法。
方法
此前尚无肾移植患者接受BCG治疗的经验。理论上，免疫抑制是禁忌，因为存在严重发病和败血症的风险。我们介绍了3例接受免疫抑制治疗的肾移植患者，患有高级别浅表性膀胱癌和CIS，接受膀胱内BCG治疗的经验。
结果
2例患者分别在17个月和60个月时无疾病复发。1例患者疾病复发并接受了根治性膀胱切除术。肾功能无变化，也没有任何结核感染的临床证据。
结论
膀胱内BCG治疗浅表性膀胱癌和/或CIS是一种有效的选择，对肾移植患者不会增加发病率。
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