Département des Maladies Infectieuses et Tropicales des Hôpitaux Saint-Louis/Lariboisière, Paris, France.
Service d'hématologie, greffe, hôpital Saint-Louis, Paris, France.
Bone Marrow Transplant. 2022 Aug;57(8):1287-1294. doi: 10.1038/s41409-022-01665-y. Epub 2022 May 20.
BK polyomavirus (BKPyV) can cause hemorrhagic cystitis (HC) after allogeneic hematopoietic cell transplantation (allo-HCT). Recent evaluation of BKPyV HC (BKHC) incidence and risk factors are scarce. We conducted a retrospective single-center study on a recent allo-HCT cohort over 3 years in a referral academic hospital for hematological malignancies. Primary objective was to determine BKHC incidence using competitive risk analysis. Secondary objectives were the identification of HC risk factors using Fine and Gray models and the evaluation of mortality. Among 409 allo-HCT recipients (median age 47 years), 41 developed BKHC after a median delay of 41 [32-55] days. Incidence density of BKHC was 2.4 [1.8-3.1] events per 100 days post-allo-HCT. The proportion of BKHC after adjustment for time-dependent competing risk was 9.5 [9.5-9.6]% at 100 days. BK viremia was detected in 63 versus 20% in tested patients with and without BKHC, respectively. After adjustment for confounders, myeloablative conditioning regimen with and without cyclophosphamide and CMV seropositivity were independently associated with BKHC. Post-transplantation cyclophosphamide was not associated with BKHC. BKHC resolved in 90% of the patients. No difference in mortality was found between patients with or without BKHC. In parallel to the recent evolution of allo-HCT protocols, BKHC remains a frequent complication following allo-HCT.
BK 多瘤病毒（BKPyV）可导致异基因造血细胞移植（allo-HCT）后发生出血性膀胱炎（HC）。近期对 BKPyV HC（BKHC）发生率和危险因素的评估很少。我们在一家血液病学专科医院对最近的 allo-HCT 队列进行了一项为期 3 年的回顾性单中心研究。主要目的是使用竞争风险分析确定 BKHC 的发生率。次要目的是使用 Fine 和 Gray 模型确定 HC 危险因素，并评估死亡率。在 409 例 allo-HCT 受者（中位年龄 47 岁）中，41 例在中位时间 41 [32-55]天后发生 BKHC。BKHC 的发生率密度为每 100 天 post-allo-HCT 2.4 [1.8-3.1]例。在调整时间依赖性竞争风险后，100 天时 BKHC 的比例为 9.5 [9.5-9.6]%。BK 病毒血症在有和无 BKHC 的检测患者中分别为 63%和 20%。在调整混杂因素后，含环磷酰胺和不含环磷酰胺的清髓性预处理方案以及 CMV 血清阳性与 BKHC 独立相关。移植后环磷酰胺与 BKHC 无关。BKHC 在 90%的患者中得到解决。有无 BKHC 的患者之间的死亡率没有差异。与 allo-HCT 方案的近期进展相平行，BKHC 仍然是 allo-HCT 后的常见并发症。
