Gender mismatch, use of anti-thymoglobulin, and occurrence of graft-versus-host disease in preparative regimen are associated with high incidence of post-engraftment hemorrhagic cystitis in allogeneic hematopoietic stem cell transplantation
10.3760/cma.j.issn.1009-9921.2013.07.009
- VernacularTitle:异基因造血干细胞移植后迟发性出血性膀胱炎与移植供受体性别差异、抗胸腺细胞球蛋白应用及急性移植物抗宿主病有关
- Author:
Ling WANG
;
Wei TANG
;
Ying WANG
;
Jiehui SHAN
;
Hanbo DOU
;
Xing FAN
;
Jiong HU
- Publication Type:Journal Article
- Keywords:
Hemorrhagic cystitis;
Hematopoietic stem cell transplantation,allogeneic;
Risk factors
- From:
Journal of Leukemia & Lymphoma
2013;22(7):410-414
- CountryChina
- Language:Chinese
-
Abstract:
Objective To evaluate the risk factors of developing post-engraftment hemorrhagic cystitis (HC) in patients receiving allogeneic stem cell transplantation (allo-HSCT).Methods Retrospective data was collected from 92 patients with acute leukemia (acute myeloid leukemia 41 and acute lymphoblastic leukemia 51) who underwent allo-HSCT from 2000 to 2010,and the association of pre-transplantation parameters with the incidence of post-engraftment HC was analyzed.Results Forty-three patients had HLA-matched donors and 49 had unrelated donors.Of these patients,25 developed HC at a median of 35 days (day +20 to +65) after allo-HSCT.In the univariate analysis,unrelated donor,gender mismatch (female donor to male recipient),conditioning containing busulfan,graft-versus-host disease (GVHD),prophylaxis with cyclosporine (CSA) + methotrexate (MTX) + mycophenolate mofetil (MMF),use of anti-thymoglobulin (ATG) and development of GVHD were associated with increased incidence of HC.In the multivariate study,gender mismatch (P =0.001),use of ATG (P ＜ 0.001),and GVHD (P =0.007) remain as independent factors for the increased risk of HC.More importantly,with these 3 factors,it is able to classify patients into 4 groups with risk of postengraftment HC at (7.7±4.6) ％,(22.9±7.1) ％,(48.2±10.5) ％,and 100.0 ％,respectively.Conclusion This retrospective study identified the gender mismatch,use of ATG in the preparation regimen,and aGVHD as important risk factors to predict the development of post-engraftment HC.Based on these risk factors,it is possible to classify patients into different risk groups for post-engraftment HC.Prospective study with a large cohort of patients is warranted to confirm the findings.Future clinical trial for HC prevention and treatment must be carried out on the intermediate and high-risk patients.
