Bil-Lula I, Ussowicz M, Rybka B, Wendycz-Domalewska D, Ryczan R, Gorczyńska E, Kałwak K, Woźniak M
Department of Clinical Chemistry, University of Medicine, Wrocław, Poland.
Transplant Proc. 2010 Nov;42(9):3729-34. doi: 10.1016/j.transproceed.2010.08.049.
Late-onset hemorrhagic cystitis (HC) caused by adenovirus (AdV) infection is a common complication in hematopoietic stem cell transplantation (HSCT) recipients. However, limited information exists regarding adenovirus-associated HC. We report a retrospective study of 84 hematopoietic stem cell transplant recipients that evaluated the incidence and risk factors for AdV-induced HC. The development of HC was strongly related to adenoviral infection (P = .004). Among 13 patients who developed late-onset HC, AdVs were identified as a causative agent in 10 cases. AdV preferentially affected younger (P = .013) and male patients. Affected subjects had been transplanted for either malignant (7/10) or nonmalignant disorders (3/10). Most cases of AdV-hematuria were self-limited single or recurrent mild hemorrhagic episodes (P = .000), occurring at a median of 41 days after transplantation and lasting an average of 4 days. Viral load in patients with AdV-induced HC was similar to infected subjects who did not develop HC (2.5 × 10(3) vs 3.4 × 10(3) copies/mL). We HC occurring before 200 days was associated with a greater risk of a fatal outcome (P = .002) but occurrence of AdV infection did not affect a patient's survival. Our study confirmed the suggestion that non-AdV coinfections may worsen the course of AdV-HC.
腺病毒（AdV）感染所致的迟发性出血性膀胱炎（HC）是造血干细胞移植（HSCT）受者常见的并发症。然而，关于腺病毒相关性HC的信息有限。我们报告了一项对84例造血干细胞移植受者的回顾性研究，评估了AdV所致HC的发病率和危险因素。HC的发生与腺病毒感染密切相关（P = .004）。在13例发生迟发性HC的患者中，10例确定AdV为病原体。AdV优先感染年轻患者（P = .013）和男性患者。受影响的受试者因恶性疾病（7/10）或非恶性疾病（3/10）接受移植。大多数AdV血尿病例为自限性单次或复发性轻度出血发作（P = .000），发生于移植后中位数41天，平均持续4天。AdV所致HC患者的病毒载量与未发生HC的感染受试者相似（2.5×10³对3.4×10³拷贝/mL）。我们发现移植后200天内发生HC与更高的死亡风险相关（P = .002），但AdV感染的发生并不影响患者的生存。我们的研究证实了非AdV合并感染可能会使AdV-HC病情恶化的观点。
