Hematology and Stem Cell Transplantation, Hospital Pablo Tobón Uribe, Medellín, Colombia.
Epidemiology and Public Health, Universidad CES, Medellín, Colombia.
Biol Blood Marrow Transplant. 2020 Aug;26(8):1492-1496. doi: 10.1016/j.bbmt.2020.04.028. Epub 2020 May 15.
Hemorrhagic cystitis (HC) is an important complication after haploidentical hematopoietic stem cell transplantation (haplo-HSCT) with post-transplantation cyclophosphamide (PT-CY). Sodium 2-mercaptoethanesulfonate (MESNA) can prevent bladder injury when given with PT-CY. However, the best way to deliver MESNA is not known. This study assessed the incidence of HC after haplo-HSCT with PT-CY with 2 different methods of MESNA administration. The cumulative incidence of HC was lower in patients who received MESNA as a continuous infusion compared with those who received it as an intermittent bolus (5.6% versus 27.8%; P = .01). MESNA administration as an infusion was associated with a lower risk of developing HC (hazard ratio [HR], .19; 95% confidence interval [CI], .04 to .86; P = .02) on univariate analysis. This effect remained significant after adjustment in multivariate analysis (HR, .21; 95% CI, .04 to .88; P = .03). MESNA delivered as a continuous infusion is a simple and potentially useful way to prevent HC after PT-CY.
出血性膀胱炎（HC）是在接受异基因造血干细胞移植（haplo-HSCT）联合环磷酰胺（PT-CY）后出现的一种重要并发症。当与 PT-CY 一起使用时，巯乙磺酸钠（MESNA）可以预防膀胱损伤。然而，目前尚不清楚使用 MESNA 的最佳方法。本研究评估了接受 PT-CY 治疗的 haplo-HSCT 后采用 2 种不同 MESNA 给药方式发生 HC 的发生率。与接受间歇性推注的患者相比，接受连续输注 MESNA 的患者 HC 的累积发生率较低（5.6% vs. 27.8%；P=.01）。在单因素分析中，MESNA 连续输注给药与发生 HC 的风险降低相关（危险比 [HR]，0.19；95%置信区间 [CI]，0.04 至 0.86；P=.02）。在多因素分析中调整后，这种影响仍然显著（HR，0.21；95%CI，0.04 至 0.88；P=.03）。MESNA 连续输注给药是预防 PT-CY 后发生 HC 的一种简单且可能有用的方法。
