Dybko Jarosław, Piekarska Agnieszka, Agrawal Siddarth, Makuch Sebastian, Urbaniak-Kujda Donata, Biernat Monika, Rybka Blanka, Dutka Magdalena, Sadowska-Klasa Alicja, Giebel Sebastian, Gil Lidia
Department of Hematology and Cellular Transplantation, Lower Silesian Oncology Center, 53-413 Wroclaw, Poland.
Department of Hematology and Transplantology, Medical University of Gdansk, 80-214 Gdansk, Poland.
Cancers (Basel). 2022 Feb 1;14(3):764. doi: 10.3390/cancers14030764.
BK virus reactivation increases the likelihood of hemorrhagic cystitis (HC) after allogeneic hematopoietic stem cell transplant (HCT). In this study, we aimed to identify predictive and risk factors associated with the increased occurrence of this condition following HCT. On a group of 124 patients aged ≤71 years old (median 40 years) who underwent HCT, we analyzed sex, age, time from diagnosis to transplantation, type of conditioning, donor's relationship, age, and sex, the impact of immunosuppression with different drugs, and acute and chronic GVHD, BK viremia and viruria as potential factors increasing the risk of BK-related HC after HCT. HC occurred among 24 patients (24/124; 29.2%). A significant correlation was observed between HC incidences after HCT, BK viremia and viruria, and acute GVHD occurrence. Furthermore, the level of BKV DNA in serum at day +21 (>0.75 × 10) significantly impacted the patients' survival time. According to our results, the likelihood ratio of BKV-DNA on day +21 in serum is 6.25, indicating that this diagnostic test has the potential to be utilized in a clinical setting. These findings may be used as a voice in the discussion on implementing an optimal preemptive treatment in BKV reactivation after allogeneic HCT.
BK病毒再激活会增加异基因造血干细胞移植（HCT）后出血性膀胱炎（HC）的发生可能性。在本研究中，我们旨在确定与HCT后该病症发生率增加相关的预测因素和风险因素。在一组124例年龄≤71岁（中位年龄40岁）接受HCT的患者中，我们分析了性别、年龄、从诊断到移植的时间、预处理类型、供者关系、供者年龄和性别、不同药物免疫抑制的影响以及急性和慢性移植物抗宿主病（GVHD）、BK病毒血症和病毒尿作为HCT后增加BK相关HC风险的潜在因素。24例患者（24/124；29.2%）发生了HC。观察到HCT后HC发生率、BK病毒血症和病毒尿以及急性GVHD发生之间存在显著相关性。此外，+21天时血清中BKV DNA水平（>0.75×10）对患者生存时间有显著影响。根据我们的结果，血清中+21天时BKV-DNA的似然比为6.25，表明该诊断测试有在临床环境中应用的潜力。这些发现可作为在讨论异基因HCT后BK病毒再激活时实施最佳抢先治疗的依据。
