Abstract

IntroductionThis study is to investigate the effect of late-onset hemorrhagic cystitis (LOHC) on progression-free survival (PFS) of patients after haploidentical peripheral blood hematopoietic stem cell transplantation (haplo-PBSCT).MethodsThis retrospective study enrolled 74 patients with hematological malignancies treated with a myeloablative conditioning regimen and haplo-PBSCT. The effect of LOHC on PFS was studied in terms of HC occurrence, grade, disease type, duration, onset time, gender, and age.ResultsThere were 28 patients with LOHC, and no case was with early-onset HC. The cumulative incidence of LOHC was 37.8% (95% CI: 26.9–48.7%). The 2-year expected PFS of 74 patients and 34 AML patients was not significantly different between LOHC patients and patients without HC (P > 0.05). Among 27 ALL patients, the 2-year expected PFS of LOHC patients was 75%, significantly higher than patients without HC (54.2%) (P < 0.05). The 2-year expected PFSs of patients with mild LOHC and severe LOHC were 69.8 and 77.8%, respectively (P > 0.05). Similarly, the onset time, duration, age, and gender of LOHC patients did not show significant effects on PFS (P > 0.05).ConclusionsAfter haplo-PBSCT, LOHC has a significant effect on the PFS of ALL patients. The HC grade, duration, onset time, gender, and age have no significant effect on PFS.

Highlights

  • Allo-genetic hematopoietic stem cell transplantation is currently one of the effective treatments for hematological malignancies

  • Hemorrhagic cystitis (HC) is a common complication after allo-HSCT, caused by many factors

  • Some studies have shown that the occurrence of late-onset hemorrhagic cystitis (LOHC) is related to CMV, influenza virus, etc. [15,16]

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Summary

Introduction

Allo-genetic hematopoietic stem cell transplantation (alloHSCT) is currently one of the effective treatments for hematological malignancies. Hemorrhagic cystitis (HC) is one of the common and serious complications of alloHSCT. It has been reported that HC is mainly the result of diffuse inflammation and vascular damage of the bladder mucosa caused by immunosuppression and opportunistic infections [1]. According to the time of occurrence, it can be divided into early-onset hemorrhagic cystitis (EOHC) and late-onset hemorrhagic cystitis (LOHC). EOHC occurs within 28–72 h of pretreatment, while LOHC occurs 72 h after pretreatment. Its clinical symptoms are mostly hematuria (manifested from microscopic hematuria, mild urine symptoms to severe bleeding and blood clots), frequent urination, and urgent urination, painful urination, and other bladder irritation symptoms. Mild HC can heal spontaneously while severe HC can cause urinary tract obstruction or renal insufficiency [6]

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