Sun Chun-Hong, Wang Xiao-Ning, Luo Min-Na, Guo Cai-Li, Qi Shi-Huan, Zhang Bei-Rong, Wang Fang, Zhang Huan, He Peng-Cheng
Department of Hematology，The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an 710061, Shaanxi Province, China.
Department of Hematology，The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an 710061, Shaanxi Province, China,E-mail:
Zhongguo Shi Yan Xue Ye Xue Za Zhi. 2021 Apr;29(2):610-614. doi: 10.19746/j.cnki.issn.1009-2137.2021.02.048.
To analyze the risk factors affecting hemorrhagic cystitis(HC) after allogeneic hematopoietic stem cell transplantation(allo-HSCT).
The clinical data of 153 patients underwent allogeneic hematopoietic stem cell transplantation in the First Affiliated Hospital of Xi'an Jiaotong University from January 2010 to December 2018 were selected and retrospectively analyzed. The incidence, median time and treatment outcome of HC should be observed. Multivariate analysis was used to observe the risk factors of HC in patients, including sex, age, diagnosis, disease status before transplantation, transplantation type, ATG and CTX in the pretreatment scheme, stem cell source, neutrophil and platelet implantation time; CMV, EBV and BKV infection, and acute graft-versus-host disease(aGVHD).
Among 153 patients underwent allogeneic hematopoietic stem cell transplantation, 25 (16.34%) patients had HC, the median occurance time was 31 days, all patients achieved complete remission after treatment, no bladder irritation and bladder contracture were left. The results of univariate and multivariate Logistic regression analysis showed that the type of transplantation, ATG, CMV viremia before treatment, aGVHD (r=1.036, 3.234, 3.298 and 2.817, respectively) were the independent risk factors of HC.
The urinary BKV detections in the patients with HC are positive, mainly occured during the period from day +13 to days +56. HLA haplotype, pretreatment including ATG, and CMV viremia, and aGVHD are the independent risk factors for HC after allo-HSCT.
分析异基因造血干细胞移植（allo-HSCT）后影响出血性膀胱炎（HC）的危险因素。
选取2010年1月至2018年12月在西安交通大学第一附属医院接受异基因造血干细胞移植的153例患者的临床资料进行回顾性分析。观察HC的发生率、中位时间及治疗结局。采用多因素分析观察患者发生HC的危险因素，包括性别、年龄、诊断、移植前疾病状态、移植类型、预处理方案中的抗胸腺细胞球蛋白（ATG）和环磷酰胺（CTX）、干细胞来源、中性粒细胞和血小板植入时间；巨细胞病毒（CMV）、EB病毒（EBV）和BK病毒（BKV）感染，以及急性移植物抗宿主病（aGVHD）。
153例接受异基因造血干细胞移植的患者中，25例（16.34%）发生HC，中位发生时间为31天，所有患者治疗后均达到完全缓解，未遗留膀胱刺激症状及膀胱挛缩。单因素和多因素Logistic回归分析结果显示，移植类型、ATG、治疗前CMV病毒血症、aGVHD（r分别为1.036、3.234、3.298和2.817）是HC的独立危险因素。
HC患者尿BKV检测呈阳性主要发生在+13天至+56天期间。HLA单倍型、含ATG的预处理、CMV病毒血症及aGVHD是allo-HSCT后发生HC的独立危险因素。
