Every year 50,000 patients receive a stem cell transplantation worldwide, but there is lack of data pertaining to urological complications. Methods: We performed a retrospective analysis of all adult patients undergoing their first allogenic stem cell transplantation from January 2011 to June 2013 in our institution. Statistical tests performed were Pearson's correlation, chi-square testing and logistic regression using SPSS 22.0. Results: We identified 39 patients (22 males, 17 females). Twenty four patients (61.5%) had a urological complication. Most frequent urologic complications were bacterial urinary tract infection (n = 13; 33.3%), acute renal failure (n = 6; 15.4%) and BK virus-associated haemorrhagic cystitis (n = 5; 12.8%). BK viruria was detected in 12 patients (30.8%). We observed an association of creatinine increase (about 20 µmol/l at time of onset of BK viruria) with BK viruria (Pearson's correlation 0.64; p = 0.01), and BK viruria is significantly linked to acute renal failure (Pearson's correlation 0.35; p = 0.029). In univariate regression, BK viruria is significantly linked to urological complication (p = 0.025). Conclusions: We suggest that BK virus infection during stem cell transplantation can lead to BK virus associated nephropathy, which is so far only known from patients after kidney transplantation.

Keywords:
BK-virus, Haemorrhagic cystitis, Nephropathy, Stem cell transplantation, Urological complications
1.
Majhail NS, Rizzo JD, Lee SJ, et al: Recommended screening and preventive practices for long-term survivors after hematopoietic cell transplantation. Bone Marrow Transplant 2012;47:337-341.
2.
Gorczynska E, Turkiewicz D, Rybka K, et al: Incidence, clinical outcome, and management of virus-induced hemorrhagic cystitis in children and adolescents after allogeneic hematopoietic cell transplantation. Biol Blood Marrow Transplant 2005;11:797-804.
3.
Mitchell RT, Saunders PT, Sharpe RM, Kelnar CJ, Wallace WH: Male fertility and strategies for fertility preservation following childhood cancer treatment. Endocr Dev 2009;15:101-134.
4.
Niedzielska E, Wojcik D, Barg E, et al: [Evaluation of selected endocrine complications in patients treated with auto- and allo-haematopoietic stem cell transplantation]. Med Wieku Rozwoj 2008;12:761-766.
5.
Steffens M, Beauloye V, Brichard B, et al: Endocrine and metabolic disorders in young adult survivors of childhood acute lymphoblastic leukaemia (ALL) or non-Hodgkin lymphoma (NHL). Clin Endocrinol (Oxf) 2008;69:819-827.
6.
Tromp K, Claessens JJ, Knijnenburg SL, et al: Reproductive status in adult male long-term survivors of childhood cancer. Hum Reprod 2011;26:1775-1783.
7.
Zaletel LZ, Bratanic N, Jereb B: Gonadal function in patients treated for Hodgkin's disease in childhood. Radiol Oncol 2010;44:187-193.
8.
Efros MD, Ahmed T, Coombe N, Choudhury MS: Urologic complications of high-dose chemotherapy and bone marrow transplantation. Urology 1994;43:355-360.
9.
Kwak EJ, Vilchez RA, Randhawa P, Shapiro R, Butel JS, Kusne S: Pathogenesis and management of polyomavirus infection in transplant recipients. Clin Infect Dis 2002;35:1081-1087.
10.
Siguier M, Sellier P, Bergmann JF: BK-virus infections: a literature review. Med Mal Infect 2012;42:181-187.
11.
Gilis L, Morisset S, Billaud G, et al: High burden of BK virus-associated hemorrhagic cystitis in patients undergoing allogeneic hematopoietic stem cell transplantation. Bone Marrow Transplant 2014;49:664-670.
12.
Tong A, Flemming K, McInnes E, Oliver S, Craig J: Enhancing transparency in reporting the synthesis of qualitative research: ENTREQ. BMC Med Res Methodol 2012;12:181.
13.
Busemann C, Neumann T, Schulze M, et al: Low-dose alemtuzumab vs. standard policy for prevention of graft-versus-host disease in unrelated and related allogeneic stem cell transplantation - a matched pair analysis. Ann Hematol 2013;92:945-952.
14.
Kruger WH, Bohlius J, Cornely OA, et al: Antimicrobial prophylaxis in allogeneic bone marrow transplantation. Guidelines of the infectious diseases working party (AGIHO) of the German society of haematology and oncology. Ann Oncol 2005;16:1381-1390.
15.
Uhm J, Hamad N, Michelis FV, et al: The risk of polyomavirus BK-associated hemorrhagic cystitis after allogeneic hematopoietic SCT is associated with myeloablative conditioning, CMV viremia and severe acute GvHD. Bone Marrow Transplant 2014;49:1528-1534.
16.
Gargiulo G, Orlando L, Alberani F, et al: Haemorrhagic cystitis in haematopoietic stem cell transplantation (HSCT): a prospective observational study of incidence and management in HSCT centres within the GITMO network (Gruppo Italiano Trapianto Midollo Osseo). Ecancermedicalscience 2014;8:420.
17.
Mackall C, Fry T, Gress R, Peggs K, Storek J, Toubert A: Background to hematopoietic cell transplantation, including post-transplant immune recovery. Bone Marrow Transplant 2009;44:457-462.
© 2016 S. Karger AG, Basel
2016
Copyright / Drug Dosage / Disclaimer
Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher.
Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug.
Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.
You do not currently have access to this content.