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  • Carreira, Abel SantosUniv Toronto, Dept Med, Sect Med Oncol & Hematol, Toronto, ON, Canada.;Univ Hlth Network, Princess Margaret Canc Ctr, Hans Messner Allogene Blood & Marrow Transplantat, Div Med Oncol & Hematol, Toronto, ON, Canada. (author)

Interaction Between High-Dose Intravenous Busulfan and Post-Transplantation Cyclophosphamide on Hemorrhagic Cystitis After Allogeneic Hematopoietic Cell Transplantation

  • Article/chapterEnglish2023

Publisher, publication year, extent ...

  • Elsevier,2023
  • printrdacarrier

Numbers

  • LIBRIS-ID:oai:DiVA.org:uu-515590
  • https://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-515590URI
  • https://doi.org/10.1016/j.jtct.2023.07.007DOI
  • http://kipublications.ki.se/Default.aspx?queryparsed=id:153926823URI

Supplementary language notes

  • Language:English
  • Summary in:English

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  • Subject category:ref swepub-contenttype
  • Subject category:art swepub-publicationtype

Notes

  • This study investigates the incidence and predictors of hemorrhagic cystitis (HC) in 960 adults undergoing allo- hematopoietic stem cell transplantation. Two hundred fifty-two (26.5%) patients received myeloablative conditioning regimens, and 81.4% received high-dose intravenous busulfan (HD Bu). Six hundred ninety-five (72.4%) patients received post-transplantation cyclophosphamide (PTCY)-based prophylaxis, and 91.4% additionally received anti-thymocyte globulin (ATG) and Cyclosporine A (CsA) (PTCY-ATG-CsA). Two hundred twenty-eight (23.8%) patients developed HC. The day 100 cumulative incidences of grades 2-4 and 3-4 HC were 11.1% and 4.9%. BK virus was isolated in 58.3% of urinary samples. Using HD BU myeloablative regimens increased the risk for grade 2-4 HC (hazard ratio [HR] = 1.97, P = .035), and HD BU combined with ATG-PTCY-CsA increased this 4 times (HR = 4.06, P < .001) for grade 2-4 HC compared to patients who received neither of these drugs. A significant correlation was documented between grade II-IV acute graft-versus-host disease and grade 2-4 HC (HR = 2.10, P < .001). Moreover, patients with BK-POS grade 2-4 HC had lower 1-year overall survival (HR = 1.51, P = .009) and higher non-relapse mortality (HR = 2.31, P < .001), and patients with BK-NEG grade 2-4 HC had comparable post-transplantation outcomes. In conclusion, intravenous HD Bu was identified as a predictor for grade 2-4 HC. Moreover, when HD Bu was combined with PTCY-ATG-CsA, the risk increased 4-fold. Based on the results provided by this study, preventing the onset of HC, especially in high-risk patients, is mandatory because its presence significantly increases the risk for mortality.

Subject headings and genre

Added entries (persons, corporate bodies, meetings, titles ...)

  • Salas, Maria QueraltUniv Toronto, Dept Med, Sect Med Oncol & Hematol, Toronto, ON, Canada.;Univ Hlth Network, Princess Margaret Canc Ctr, Hans Messner Allogene Blood & Marrow Transplantat, Div Med Oncol & Hematol, Toronto, ON, Canada.;Hosp Clin Barcelona, Dept Hematol, Hematopoiet Cell Transplant Unit, IDIBAPS, Barcelona, Spain. (author)
  • Remberger, Mats,Professor,1955-Uppsala universitet,Hematologi,Uppsala Univ Hosp, KFUE, Uppsala, Sweden.(Swepub:uu)matre804 (author)
  • Novitzky-Basso, IgorPrincess Margaret Hosp, Canc Ctr, Toronto, ON, Canada. (author)
  • Law, Arjun DattUniv Toronto, Dept Med, Sect Med Oncol & Hematol, Toronto, ON, Canada.;Univ Hlth Network, Princess Margaret Canc Ctr, Hans Messner Allogene Blood & Marrow Transplantat, Div Med Oncol & Hematol, Toronto, ON, Canada. (author)
  • Lam, WilsonUniv Toronto, Dept Med, Sect Med Oncol & Hematol, Toronto, ON, Canada.;Univ Hlth Network, Princess Margaret Canc Ctr, Hans Messner Allogene Blood & Marrow Transplantat, Div Med Oncol & Hematol, Toronto, ON, Canada. (author)
  • Pasic, IvanUniv Toronto, Dept Med, Sect Med Oncol & Hematol, Toronto, ON, Canada.;Univ Hlth Network, Princess Margaret Canc Ctr, Hans Messner Allogene Blood & Marrow Transplantat, Div Med Oncol & Hematol, Toronto, ON, Canada. (author)
  • Mazzulli, TonyUniv Toronto, Dept Lab Med & Pathobiol, Toronto, ON, Canada.;Sinai Hlth Syst, Dept Microbiol, Univ Hlth Network, Toronto, ON, Canada. (author)
  • Cserti-Gazdewich, ChristineUniv Toronto, Dept Med, Sect Med Oncol & Hematol, Toronto, ON, Canada.;Univ Toronto, Dept Lab Med & Pathobiol, Toronto, ON, Canada.;Univ Hlth Network, Lab Med Program, Blood Transfus Lab, Toronto, ON, Canada. (author)
  • Kim, Dennis (Dong Hwan)Univ Toronto, Dept Med, Sect Med Oncol & Hematol, Toronto, ON, Canada.;Univ Hlth Network, Princess Margaret Canc Ctr, Hans Messner Allogene Blood & Marrow Transplantat, Div Med Oncol & Hematol, Toronto, ON, Canada. (author)
  • Michelis, Fotios, VUniv Toronto, Dept Med, Sect Med Oncol & Hematol, Toronto, ON, Canada.;Univ Hlth Network, Princess Margaret Canc Ctr, Hans Messner Allogene Blood & Marrow Transplantat, Div Med Oncol & Hematol, Toronto, ON, Canada. (author)
  • Viswabandya, AuroUniv Toronto, Dept Med, Sect Med Oncol & Hematol, Toronto, ON, Canada.;Univ Hlth Network, Princess Margaret Canc Ctr, Hans Messner Allogene Blood & Marrow Transplantat, Div Med Oncol & Hematol, Toronto, ON, Canada. (author)
  • Gerbitz, ArminUniv Toronto, Dept Med, Sect Med Oncol & Hematol, Toronto, ON, Canada.;Univ Hlth Network, Princess Margaret Canc Ctr, Hans Messner Allogene Blood & Marrow Transplantat, Div Med Oncol & Hematol, Toronto, ON, Canada. (author)
  • Lipton, Jeffrey HowardUniv Toronto, Dept Med, Sect Med Oncol & Hematol, Toronto, ON, Canada.;Univ Hlth Network, Princess Margaret Canc Ctr, Hans Messner Allogene Blood & Marrow Transplantat, Div Med Oncol & Hematol, Toronto, ON, Canada. (author)
  • Kumar, RajatUniv Toronto, Dept Med, Sect Med Oncol & Hematol, Toronto, ON, Canada.;Univ Hlth Network, Princess Margaret Canc Ctr, Hans Messner Allogene Blood & Marrow Transplantat, Div Med Oncol & Hematol, Toronto, ON, Canada. (author)
  • Hassan, MoustaphaKarolinska Institutet (author)
  • Mattsson, JonasUniv Toronto, Dept Med, Sect Med Oncol & Hematol, Toronto, ON, Canada.;Univ Hlth Network, Princess Margaret Canc Ctr, Hans Messner Allogene Blood & Marrow Transplantat, Div Med Oncol & Hematol, Toronto, ON, Canada.;Univ Hlth Network, Princess Margaret Canc Ctr, Hans Messner Allogene Transplant Program, Div Med Oncol & Hematol, OPG Bldg,610 Univ Ave, Toronto, ON M5G 2M9, Canada. (author)
  • Univ Toronto, Dept Med, Sect Med Oncol & Hematol, Toronto, ON, Canada.;Univ Hlth Network, Princess Margaret Canc Ctr, Hans Messner Allogene Blood & Marrow Transplantat, Div Med Oncol & Hematol, Toronto, ON, Canada.Univ Toronto, Dept Med, Sect Med Oncol & Hematol, Toronto, ON, Canada.;Univ Hlth Network, Princess Margaret Canc Ctr, Hans Messner Allogene Blood & Marrow Transplantat, Div Med Oncol & Hematol, Toronto, ON, Canada.;Hosp Clin Barcelona, Dept Hematol, Hematopoiet Cell Transplant Unit, IDIBAPS, Barcelona, Spain. (creator_code:org_t)

Related titles

  • In:Transplantation and Cellular Therapy: Elsevier29:9, s. 581.e1-581.e82666-63752666-6367

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