Kidney and Bladder Outcomes in Children with Hemorrhagic Cystitis and BK Virus Infection after Allogeneic Hematopoietic Stem Cell Transplantation

Benjamin Oshrine, Nancy Bunin, Yimei Li, Susan Furth, Benjamin L. Laskin

Research output: Contribution to journalArticle

Abstract

BK virus (BKV) infection is associated with hemorrhagic cystitis (HC) in hematopoietic stem cell transplantation (HSCT) recipients and nephropathy after kidney transplantation. We assessed the association between BKV and kidney and bladder complications in children developing HC by retrospectively reviewing 221 consecutive pediatric allogeneic HSCT recipients at the Children's Hospital of Philadelphia from 2005 to 2011. We included all patients with BKV PCR testing performed for clinical indication from day 0 until 1 year post-HSCT (N= 68). We assessed the association of any BKV infection (urine and/or blood) or peak BK viremia < 10,000 copies/mL (high viremia) with severe HC (defined as grade IV-bladder catheterization or surgical intervention); the need for dialysis; serum creatinine-estimated glomerular filtration rate at the time of BKV testing, day 100, and day 365; and death. Children with high viremia more likely developed severe HC compared with those with peak viremia < 10,000 copies/mL (21% versus 2%; P= .02). BKV infection of the blood or urine was not associated with the need for dialysis, change in estimated glomerular filtration rate, or mortality. BKV infection is common after pediatric allogeneic HSCT, and plasma testing in those with HC may predict patients who will develop severe bladder injury.

Original languageEnglish (US)
Pages (from-to)1702-1707
Number of pages6
JournalBiology of Blood and Marrow Transplantation
Volume19
Issue number12
DOIs
StatePublished - Dec 1 2013

Keywords

  • BK virus
  • Hemorrhagic cystitis
  • Pediatrics
  • Transplantation

ASJC Scopus subject areas

  • Hematology
  • Transplantation

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