Kesherwani V, Guzman Vinasco L F, Awaji M, Bociek R G, Meza J, Shostrom V K, Freifeld A G, Gebhart C
Microbiology and Pathology Department, University of Nebraska Medical Center, Omaha, Nebraska.
Internal Medicine, University of Nebraska Medical Center, Omaha, Nebraska.
Transplant Proc. 2018 Jun;50(5):1504-1509. doi: 10.1016/j.transproceed.2018.03.021. Epub 2018 Mar 12.
In a retrospective case-control study, we aimed to assess the utility of plasma BK viral load value to predict hemorrhagic cystitis (HC) symptoms after allogeneic hematopoietic stem cell transplantation (alloHSCT). During first 100 post-transplantation days of all adult AlloHSCT recipients at the University of Nebraska Medical Center from October 1, 2011, to June 30, 2014, 8 unexcluded cases of HC were identified and matched with 88 unexcluded unaffected control cases. Viral loads were determined for archived DNA extracted from plasma collected within 3 weeks before transplantation until ∼100 days after transplantation. Clinical factors, time of onset of BK viremia, and BK viral load were compared between case and control subjects to identify risks for HC. Symptomatic HC occurred in 8/96 (8.3%) of patients at a median of 34 days after transplantation. BK viremia either before or during symptoms was detected in all 8 (100%) HC patients and in 20/88 (22.7%) of control subjects. BK viremia was detected at a median of 8 days before HC clinical symptoms. The log of first positive viral load was not a statistically significant predictor (P = .17) of symptomatic BK. Median BK viral load peak was significantly higher for 8 patients with HC versus 20 viremic patients without HC (6.66 vs 5.06; P < .052). Further study is required to evaluate the predictive value of the BK viral load for HC.
在一项回顾性病例对照研究中，我们旨在评估血浆BK病毒载量值对预测异基因造血干细胞移植（alloHSCT）后出血性膀胱炎（HC）症状的效用。在2011年10月1日至2014年6月30日期间，内布拉斯加大学医学中心所有成年异基因造血干细胞移植受者移植后的前100天内，确定了8例未排除的HC病例，并与88例未排除的未受影响的对照病例进行匹配。对从移植前3周内采集的血浆中提取的存档DNA进行病毒载量测定，直至移植后约100天。比较病例组和对照组的临床因素、BK病毒血症的发病时间和BK病毒载量，以确定HC的风险因素。8/96（8.3%）的患者在移植后中位数34天出现有症状的HC。所有8例（100%）HC患者以及20/88（22.7%）的对照受试者在症状出现前或出现期间检测到BK病毒血症。BK病毒血症在HC临床症状出现前中位数8天被检测到。首次阳性病毒载量的对数不是有症状BK的统计学显著预测指标（P = 0.17）。8例HC患者的BK病毒载量峰值中位数显著高于20例无HC的病毒血症患者（6.66对5.06；P < 0.052）。需要进一步研究来评估BK病毒载量对HC的预测价值。
