Hemorrhagic cystitis following allogeneic bone marrow transplantation for children

Abstract

  Hemorrhagic cystitis (HC) in patients who have undergone allogeneic bone marrow transplantation (BMT). We have analyzed its incidence, risk factors and clinical findings in 64 children undergoing BMT. HC occurred in 17 patients (26.6%). The median day for onset was day 35 and only 3 patients developed early onset HC. The duration of HC was between 5 and 180 days. Three patients developed severe HC requiring surgicai drainage. The average age of patients with HC was higher than that without HC, however neither underlying diseases nor the severity of the GVHD was significantly associated with frequency of HC. Adenovirus was isolated from three patients, whose symptoms persisted for a long time. One of three developed interstitial nephritis and chronic renal failure. Cyclophosphamide (CY)- induced HC occurred in only 3 patients, who developed HC within two weeks after starting CY. The use of melphalan (Mel) as a conditioning agent was significantly associated with higher rates of HC (13/17). We suggest that the conditioning regimen containing Mel leads to HC after BMT, and this may be explained the higher incidence of moderate to severe mucositis observed following Mel.