Prevalence of viral infections and hemorrhagic cystitis in hematopoietic stem cell transplant recipients.

OBJECTIVES About 7% to 70% of hemorrhagic cystitis is classified as early and late-onset incidence in hematopoietic stem cell transplant patients. The association between the prevalence of viral infections and hemorrhagic cystitis was evaluated in pretransplant and posttransplant recipients and donors. MATERIALS AND METHODS Ethylenediaminetetra-acetic acid-treated blood and urine samples of 30 recipients and 24 donors were collected before hematopoietic stem cell transplant patients, and monitored for 100 days after transplant. Prevalence of BK virus DNA was investigated by polymerase chain reaction. Prevalence of adenovirus and cytomegalovirus DNA was evaluated by polymerase chain reaction. Type of transplant, conditioning regimens, graft-versus-host disease clinical grading, demographic data, hematologic, and biochemical indexes also were analyzed. RESULTS Different grades of hematuria were found in 16 of 30 of the recipients with hemorrhagic cystitis. Severe hematuria and diffuse thickening of the bladder were found in 5 of 30 transplant patients. Multiple infections of BK virus, adenovirus, and cytomegalovirus were seen in 5 patients with severe hemorrhagic cystitis. The viruria of these viruses was decreased in patients with hemorrhagic cystitis as follows: BK virus (5 of 5), adenovirus (2 of 5), and cytomegalovirus (not detected). Also, a significant relation was found between hemorrhagic cystitis and risk factors including donor-recipient sex mismatches, familial relationships, leukemia as an underlying disease, older age, allogenic type of transplant, prophylactic and therapeutic dose of anti-graft-versus-host-disease regimens. CONCLUSIONS Detection of single and multiple infections of BK virus, adenovirus, and cytomegalovirus in blood and/or urine samples of hematopoietic stem cell transplant recipients, in combination with 1 or more inducing factors of hemorrhagic cystitis were enforced on the important role these risk factors play in the cause of hemorrhagic cystitis.