Dou Hui-Hong, Luo Jian-Ming, Zhao Yan-Jun, Wang Ji-Gan, Qin Yuan-Han
Department of Pediatrics, Maternal and Child Health Hospital of Guangxi Zhuang Autonomous Region, Guangxi Clinical Research Center for Pediatric Diseases, Nanning, China.
Department of Pediatrics, The First Affiliated Hospital, Guangxi Medical University, Nanning, China.
Front Pediatr. 2025 Apr 3;13:1558099. doi: 10.3389/fped.2025.1558099. eCollection 2025.
To investigate the risk factors for hemorrhagic cystitis (HC) in children with severe beta-thalassemia after allogeneic hematopoietic stem cell transplantation (allo-HSCT).
The clinical data of 152 children under the age of 15 who underwent allo-HSCT between January 2011 and December 2021 were retrospectively analyzed. The incidence of HC and related variables were evaluated using univariate analysis. Variables with statistical significance ( < 0.05) were included in a multivariable logistic regression model to identify independent risk factors for HC.
Among the 152 children, 42 developed HC, with an incidence rate of 27.63%. The median onset time of HC was 25 days (IQR: 10-38.75 days). Univariate analysis indicated that older transplantation age, elevated pre-transplant serum ferritin levels, cytomegalovirus (CMV) infection, and prolonged neutrophil engraftment time were associated with HC occurrence ( < 0.05). Multivariable logistic regression further confirmed that older transplantation age (OR 1.236, 95% CI: 1.031-1.531, = 0.033), elevated pre-transplant ferritin levels (OR 1.053, 95% CI: 1.028-1.086, < 0.01), CMV infection (OR 11.522, 95% CI: 2.912-76.345, = 0.002), and prolonged neutrophil engraftment time (OR 1.385, 95% CI: 1.109-1.793, < 0.01) were independent risk factors for HC.
Older transplantation age (>5.95 age years old), elevated pre-transplant serum ferritin levels, CMV infection, and delayed neutrophil engraftment are independent risk factors for HC in children with severe beta-thalassemia after allo-HSCT. Early identification and intervention for these risk factors are crucial in reducing the incidence of HC.
探讨重型β地中海贫血患儿异基因造血干细胞移植（allo-HSCT）后出血性膀胱炎（HC）的危险因素。
回顾性分析2011年1月至2021年12月期间接受allo-HSCT的152例15岁以下儿童的临床资料。采用单因素分析评估HC的发生率及相关变量。将具有统计学意义（<0.05）的变量纳入多变量逻辑回归模型，以确定HC的独立危险因素。
152例儿童中，42例发生HC，发生率为27.63%。HC的中位发病时间为25天（四分位间距：10 - 38.75天）。单因素分析表明，移植年龄较大、移植前血清铁蛋白水平升高、巨细胞病毒（CMV）感染及中性粒细胞植入时间延长与HC的发生相关（<0.05）。多变量逻辑回归进一步证实，移植年龄较大（OR 1.236，95%可信区间：1.031 - 1.531，P = 0.033）、移植前铁蛋白水平升高（OR 1.053，95%可信区间：1.028 - 1.086，P < 0.01）、CMV感染（OR 11.522，95%可信区间：2.912 - 76.345，P = 0.002）及中性粒细胞植入时间延长（OR 1.385，95%可信区间：1.109 - 1.793，P < 0.01）是HC的独立危险因素。
移植年龄较大（>5.95岁）、移植前血清铁蛋白水平升高、CMV感染及中性粒细胞植入延迟是重型β地中海贫血患儿allo-HSCT后HC的独立危险因素。早期识别和干预这些危险因素对于降低HC的发生率至关重要。
