Risk factors for hemorrhagic cystitis after allogeneic hematopoietic stem cell transplantation in a letermovir-exposed CMV-free population receiving PTCy.
CMV
allogeneic hematopoietic stem cell transplantation
hemorrhagic cystitis
letermovir
Journal
European journal of haematology
ISSN: 1600-0609
Titre abrégé: Eur J Haematol
Pays: England
ID NLM: 8703985
Informations de publication
Date de publication:
Apr 2024
Apr 2024
Historique:
revised:
22
11
2023
received:
16
08
2023
accepted:
27
11
2023
pubmed:
7
1
2024
medline:
7
1
2024
entrez:
6
1
2024
Statut:
ppublish
Résumé
Hemorrhagic cystitis (HC) is a highly impacting complication in allogeneic hematopoietic stem cell transplantation (HSCT), occurring in 12%-37% of patients. The impact of transplant- and patient-specific variables has been described, with a possible role for JCV and BKV, which may be cooperating with cytomegalovirus (CMV). Here, we analyze 134 letermovir-exposed, CMV-free patients, treated with the same cyclophosphamide-based graft-versus-host disease (GVHD) prophylaxis, describing risk factors for HC. The overall incidence of HC was 23%. Patients with HLA mismatched transplant, higher comorbidity score, and receiving three alkylating agents with TBF (thiotepa, busulfan, and fludarabine) conditioning regimen had a higher risk of HC in multivariate analysis (OR: 4.48, 6.32, and 1.32, respectively). A HC-score including male gender, TBF conditioning, and HLA-mismatch stratifies the risk of HC in the first 100 days after HSCT. The role of BKV and JCV was not highly impacting in those patients, suggesting a possible synergistic effect between CMV and JCV in causing HC. HC can be interpreted as the combination of patient-related factors, chemotherapy-related toxicities-especially due to alkylating agents-and immunological elements.
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
577-584Subventions
Organisme : Centro di Ricerca sulle cellule staminali emopoietiche e le terapie cellulari 'Università Cattolica del Sacro Cuore, Roma
Informations de copyright
© 2024 The Authors. European Journal of Haematology published by John Wiley & Sons Ltd.
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