Ersoy Gizem Zengin, Bozkurt Ceyhun, Aksoy Basak Adakli, Öner Özlem Başoğlu, Aydoğdu Selime, Çipe Funda, Sütçü Murat, Özkaya Ozan, Fışgın Tunç
Altınbaş University Medical Park Bahçelievler Hospital Pediatric Hematology Oncology & Pediatric Bone Marrow Transplantation Unit, İstanbul, Turkey.
Medical Park Bahçelievler Hospital Pediatric Hematology Oncology & Pediatric Bone Marrow Transplantation Unit, İstinye University Pediatric Hematology Oncology, Istanbul, Turkey.
Pediatr Transplant. 2023 Feb;27(1):e14364. doi: 10.1111/petr.14364. Epub 2022 Jul 19.
BKV-HC is one of the most significant complications of HSCT. This retrospective study aimed to determine the frequency of BKV-HC in pediatric patients undergoing HSCT, detect the associated risk factors for the development of BKV-HC, and explore the effects of post-transplantation Cy use.
Three hundred twenty-seven patients (girls: 121, boys: 206) were analyzed according to sex, conditioning regimen, transplantation type, donor relatedness, stem cell source, the presence and grade of aGVHD, CMV co-existence, and Cy use.
Multivariate analysis confirmed the prognostic importance of age (OR: 4.865), TBI use, the presence of aGVHD (OR: 2.794), CMV coinfection (OR: 2.261), and Cy use (OR: 27.353). A statistically significant difference was found between the mean BKV-HC follow-up times compared with post-transplantation Cy intake (p < .001). The BKV-HC rate increased as the number of risk factors of the patient increased.
BKV-HC is an essential complication of HSCT primarily associated with Cy use, the presence of aGVHD, and donor relatedness. The present study shows that the use of Cy in the post-transplantation period further increases BKV-HC risk in pediatric patients, regardless of dose.
BK病毒相关性出血性膀胱炎（BKV-HC）是造血干细胞移植（HSCT）最严重的并发症之一。本回顾性研究旨在确定接受HSCT的儿科患者中BKV-HC的发生率，检测BKV-HC发生的相关危险因素，并探讨移植后环磷酰胺（Cy）使用的影响。
根据性别、预处理方案、移植类型、供体相关性、干细胞来源、急性移植物抗宿主病（aGVHD）的存在及分级、巨细胞病毒（CMV）合并感染情况以及Cy使用情况，对327例患者（女孩121例，男孩206例）进行分析。
多因素分析证实年龄（比值比[OR]：4.865）、使用全身照射（TBI）、存在aGVHD（OR：2.794）、CMV合并感染（OR：2.261）以及使用Cy（OR：27.353）具有预后重要性。与移植后Cy摄入相比，BKV-HC的平均随访时间存在统计学显著差异（p < 0.001）。BKV-HC发生率随患者危险因素数量的增加而升高。
BKV-HC是HSCT的一种重要并发症，主要与Cy使用、aGVHD的存在以及供体相关性有关。本研究表明，移植后使用Cy会进一步增加儿科患者发生BKV-HC的风险，无论剂量如何。
