Xie Ying, Han Yue, Wu De-Pei
The First Affiliated Hospital of Soochow University, Jiangsu Institute of Hematology, Key Laboratory of Thrombosis and Hemostasis, Ministry of Health, Suzhou 215006, China.
Zhonghua Nei Ke Za Zhi. 2008 Sep;47(9):746-9.
To study the role of BK virus (BK polyomavirus) in the development of the hemorrhagic cystitis (HC) after hematopoietic stem cell transplantation (HSCT) and analyze the risk factors for BK viruria and HC.
From August 2006 to November 2007, blood and urine samples were collected from 80 patients undergoing HSCT. BK virus DNA was detected with PCR. Cytomegalovirus (CMV) antigen was detected with immunofluorescence histochemical examination. A control group including 20 healthy individuals was established.
Late-onset HC occurred in 15 of the 80 HSCT patients with an incidence of 18.8%. The median onset time of HC was 44 (13 - 150) days after transplantation. BK viruria was detected in 30 of the 80 HSCT patients (37.5%) and the positive rate of viruria in the HC patients was 86.7% (13/15). The median time of BK viruria detection in HC patients was 23 (0 - 56) days after transplantation, being earlier than the onset time of HC. The persistence time of BK viruria was 7 (2 - 14) weeks, being much longer than that of HC (11 days). CMV antigen viremia was detected in 12 of the 80 transplanted patients, with a positive rate of 36.7% in patients with BK viruria and 40.0% in HC patients. Nine of the 30 HC patients developed acute graft versus host disease (aGVHD) of grade II-IV (30.0%). BK virus was not detected in the urine of the remaining two HC patients and the 20 control subjects as well as in all the blood samples. Univariate analysis indicated that CMV viremia and aGVHD of grade II-IV were associated with the occurrence of BK viruria.
BK viruria is the main cause of the late-onset HC after HSCT. CMV infection and aGVHD may contribute to the occurrence of HC associating with BK virus.
研究BK病毒（BK多瘤病毒）在造血干细胞移植（HSCT）后出血性膀胱炎（HC）发生中的作用，并分析BK病毒尿症和HC的危险因素。
2006年8月至2007年11月，收集80例接受HSCT患者的血液和尿液样本。采用聚合酶链反应（PCR）检测BK病毒DNA。采用免疫荧光组织化学检查检测巨细胞病毒（CMV）抗原。设立包括20名健康个体的对照组。
80例HSCT患者中有15例发生迟发性HC，发生率为18.8%。HC的中位发病时间为移植后44（13 - 150）天。80例HSCT患者中有30例检测到BK病毒尿症（37.5%），HC患者中病毒尿症阳性率为86.7%（13/15）。HC患者检测到BK病毒尿症的中位时间为移植后23（0 - 56）天，早于HC发病时间。BK病毒尿症持续时间为7（2 - 14）周，远长于HC的持续时间（11天）。80例移植患者中有12例检测到CMV抗原血症，BK病毒尿症患者阳性率为36.7%，HC患者阳性率为40.0%。30例HC患者中有9例发生Ⅱ - Ⅳ级急性移植物抗宿主病（aGVHD）（30.0%）。其余2例HC患者以及20名对照受试者的尿液和所有血液样本中均未检测到BK病毒。单因素分析表明CMV血症和Ⅱ - Ⅳ级aGVHD与BK病毒尿症的发生有关。
BK病毒尿症是HSCT后迟发性HC的主要原因。CMV感染和aGVHD可能促使与BK病毒相关的HC的发生。
