Successful Treatment of Hemorrhagic Cystitis after Bone Marrow Transplantation with Prostaglandin E₁ Bladder Instillations

Abstract

A case of early onset hemorrhagic cystitis after an allogeneic bone marrow transplantation successfully treated with prostaglandin E₁bladder instillations is reported. The patient, a five-year-old boy who suffered from non-A non-B non-C hepatitis at four years of age, was rehospitalized because of anemia and thrombocytopenia, and diagnosed as having post-hepatitis aplastic anemia. After a bone marrow transplantation from a HLA identical sibling, hemorrhagic cystitis developed on day one. Bladder instillations with prostaglandin E₁ (500 μg/body) were started on day 23 because treatment with 10% Maalox^® (aluminum hydroxide gel and magnesiumhydroxide, Yamanouchi Co., Tokyo, Japan) from day 3 was not effective. The microscopic hematuria disappeared dramatically on day 29. There were no severe side effects of bladder instillations with prostaglandin E₁observed. Therefore, this treatment may be promising for the treatment of severe hemorrhagic cystitis because ofits availability without any severe systemic side effects.