Azzi A, Fanci R, Bosi A, Ciappi S, Zakrzewska K, de Santis R, Laszlo D, Guidi S, Saccardi R, Vannucchi A M
Institute of Microbiology, University of Florence, Italy.
Bone Marrow Transplant. 1994 Aug;14(2):235-40.
An association between long-lasting hemorrhagic cystitis (HC) in bone marrow transplantation (BMT) patients and viral infections, mostly with reactivation of the human polyomavirus BK (BKV), is suggested by several previous reports. We have carried out a prospective study in 55 (30 allogeneic, 24 autologous, 1 syngeneic) BMT recipients with the aim of evaluating the role of BKV in this frequent complication after BMT. To overcome the well known difficulties in BK virus isolation in cell cultures, a DNA hybridization assay and the polymerase chain reaction (PCR) were used for the detection and monitoring of viral urinary shedding, respectively. The presence of human polyomavirus JC and adenovirus DNA was also sought in urine specimens. BK viruria was demonstrated in 52.7% of patients (in 53.3% allogeneic and in 54.1% autologous BMT), whereas JCV and adenovirus were seldom present. Seven cases of HC (20% in allogeneic and 4% in autologous BMT) occurred and in all cases the clinical event was associated with BKV urinary shedding. This study suggests that BKV infection alone does not invariably lead to HC in BMT patients; for HC to occur the presence of other, at present unidentified, factors seems to be necessary.
先前的几份报告表明，骨髓移植（BMT）患者的持续性出血性膀胱炎（HC）与病毒感染之间存在关联，其中大多数是人类多瘤病毒BK（BKV）的再激活。我们对55例（30例同种异体、24例自体、1例同基因）BMT受者进行了一项前瞻性研究，目的是评估BKV在BMT后这种常见并发症中的作用。为了克服细胞培养中BK病毒分离的众所周知的困难，分别使用DNA杂交试验和聚合酶链反应（PCR）检测和监测病毒尿排泄。还在尿液标本中寻找人类多瘤病毒JC和腺病毒DNA的存在。52.7%的患者出现BK病毒尿（同种异体BMT患者中为53.3%，自体BMT患者中为54.1%），而JCV和腺病毒很少出现。发生了7例HC（同种异体BMT患者中为20%，自体BMT患者中为4%），所有病例的临床事件均与BKV尿排泄有关。这项研究表明，仅BKV感染并不总是导致BMT患者发生HC；HC的发生似乎还需要其他目前尚未确定的因素。
