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<p>This survey reports on the current practice and management of hemorrhagic cystitis (HC) among the EBMT centers. The survey response rate was 27%. The diagnostic search of BK polyomavirus (BKPyV) was available in 93% of centers and performed in urine (100%), blood/plasma (51%), and serum (12%). Patient screening for BKPyV infection was performed in 14% of centers before hematopoietic cell transplantation (HCT). In comparison, surveillance for BKPyV infection was performed after HCT in 39% of centers, mainly with a frequency of 1–2 times/week. Preventative measures are based mainly on hyperhydration and sodium 2-mercaptoethanesulphonate (Mesna), while the use of bladder catheter is limited; moreover, 23% of centers used quinolones prophylaxis.The primary therapeutic interventions are hyperhydration, Mesna, analgesics, and sustained platelet transfusions; bladder irrigation by urinary catheter is adopted by 47–50% of centers. In the case of BKPyV infection, 85% of centers use intravenous or intrabladder administration of cidofovir at a dosage ranging from 1 to 5 mg/kg. Centers report a miscellaneous range of alternative therapeutic measures (adoptive immunotherapy, hyperbaric oxygen therapy, fibrin glue/platelet-rich plasma, leflunomide, sodium hyaluronate) and the need for invasive procedures. This survey confirms that the management of HC needs further education, clinical research, and innovation.</p>

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A survey on the practices and the management of hemorrhagic cystitis in patients who undergo allogeneic hematopoietic stem cell transplantation, on behalf of the Infectious Diseases Working Party of EBMT

  • 期刊论文

  • 发表日期：

    2025年8月26日

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  • Simone Cesaro,
  • Inge Verheggen,
  • Gloria Tridello,
  • Jan Styczynski,
  • W. H. Mieke Roeven,
  • Angela Hwang,
  • Maria Stamouli,
  • Yavor Petrov,
  • Nour Ben Abdeljelil,
  • Pauline Mazilier,
  • Irina Zaidman,
  • Francesco Paolo Tambaro,
  • Shlomo Elias,
  • Marta Verna,
  • Julia Marsal Ricoma,
  • Michal Karas,
  • Lucia Lopez Corral,
  • Evgenios Goussetis,
  • Raffaella Cerretti,
  • Katia Perruccio,
  • Michaela Hornakova,
  • Matthias Wölfl,
  • Anna Nordlander,
  • Alessandra Biffi,
  • Manuela Spadea,
  • Andres Sanchez Salinas,
  • Stefania Bramanti,
  • Cristina Belendez,
  • Cristina Skert,
  • Jolanta Gozdzik,
  • Angela Cuoghi,
  • Maria Huguet Mas,
  • Martina Pennisi,
  • Ann de Becker,
  • Deborah Richardson,
  • Zinaida Peric,
  • Rafael de la Camara,
  • Dina Averbuch

摘要

This survey reports on the current practice and management of hemorrhagic cystitis (HC) among the EBMT centers. The survey response rate was 27%. The diagnostic search of BK polyomavirus (BKPyV) was available in 93% of centers and performed in urine (100%), blood/plasma (51%), and serum (12%). Patient screening for BKPyV infection was performed in 14% of centers before hematopoietic cell transplantation (HCT). In comparison, surveillance for BKPyV infection was performed after HCT in 39% of centers, mainly with a frequency of 1–2 times/week. Preventative measures are based mainly on hyperhydration and sodium 2-mercaptoethanesulphonate (Mesna), while the use of bladder catheter is limited; moreover, 23% of centers used quinolones prophylaxis.The primary therapeutic interventions are hyperhydration, Mesna, analgesics, and sustained platelet transfusions; bladder irrigation by urinary catheter is adopted by 47–50% of centers. In the case of BKPyV infection, 85% of centers use intravenous or intrabladder administration of cidofovir at a dosage ranging from 1 to 5 mg/kg. Centers report a miscellaneous range of alternative therapeutic measures (adoptive immunotherapy, hyperbaric oxygen therapy, fibrin glue/platelet-rich plasma, leflunomide, sodium hyaluronate) and the need for invasive procedures. This survey confirms that the management of HC needs further education, clinical research, and innovation.