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The calcineurin inhibitor and the intensity of the conditioning regimen may affect the occurrence of polyomavirus-associated hemorrhagic cystitis after haploidentical hematopoietic stem cell transplantation with post-transplant cyclophosphamide

Bone Marrow Transplantation volume 52, pages 135–137 (2017)Cite this article

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Late-onset hemorrhagic cystitis (HC) is a common cause of morbidity following allogeneic hematopoietic stem cell transplantation (HSCT) and is usually of infectious nature, as the recognized etiological agents are polyomavirus, adenovirus and CMV.1 Reactivation of the latent polyomaviruses (PVs) may cause a wide spectrum of diseases mostly in immunocompromised patients. The incidence of PV-associated post-HSCT HC (PV-HC) ranges between 4% and 75%. Several risk factors have been described for the development of PV-HC: intensity of the conditioning regimen, unrelated donor, cord blood transplantation, HLA mismatch, source of PBSCs, older age, high pre-HSCT BK virus (BKV) IgG antibody titer, CMV infection and possibly acute GVHD.2, 3

In the setting of renal transplantation, a prospective randomized study has reported that patients receiving tacrolimus (FK) instead of cyclosporine A (CsA) as part of the antirejection prophylaxis were at increased risk of developing BKV viremia and thus PV-associated nephropathy.4

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Acknowledgements

We thank the nursing staff for providing excellent care to our patients and the physicians of the Department of Hematology and Oncology at Humanitas Cancer Center and Institut Paoli Calmettes for their important study contributions and dedicated patient care.

Author contributions

AR conceived and designed the study, collected and analyzed data, performed statistical analysis, provided clinical care and wrote and revised the manuscript; RC conceived the study, collected and analyzed data, performed statistical analysis, provided clinical care and revised the manuscript; JE-C and AG collected data, provided clinical care and commented on the manuscript; SB, SF, BS, LM, SH, BM, RD, CF, CC and AS provided clinical care and commented on the manuscript; RM commented on the manuscript; DB and LC designed transplant program, recruited patients, provided clinical care and commented on the manuscript.

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Authors and Affiliations

  1. Humanitas Cancer Center, Istituto Clinico Humanitas, Milan, Italy

    A Rimondo, R Crocchiolo, S Bramanti, B Sarina, L Morabito, A Santoro & L Castagna

  2. Oncology-hematology, Bone Marrow Transplantation Program, American University of Beirut, Beirut, Lebanon

    J El-Cheikh

  3. Department of Hematology, Transplantation Program, Institut Paoli Calmettes, Marseille, France

    A Granata, S Furst, R Devillier, S Harbi, B Mohty, C Faucher & D Blaise

  4. Molecular Biology Section, Clinical Investigation Laboratory, Istituto Clinico Humanitas, Milan, Italy

    R Mineri

  5. Cell Therapy Unit, Institut Paoli Calmettes, Marseille, France

    C Chabannon

  6. Aix-Marseille Université, Marseille, France

    C Chabannon & D Blaise

  7. Centre de Recherche en Cancérologie de Marseille (CRCM), Marseille, France

    C Chabannon & D Blaise

Authors
  1. A Rimondo
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  2. R Crocchiolo
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  17. L Castagna
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Corresponding author

Correspondence to L Castagna.

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The authors declare no conflict of interest.

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Supplementary Information accompanies this paper on Bone Marrow Transplantation website

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Rimondo, A., Crocchiolo, R., El-Cheikh, J. et al. The calcineurin inhibitor and the intensity of the conditioning regimen may affect the occurrence of polyomavirus-associated hemorrhagic cystitis after haploidentical hematopoietic stem cell transplantation with post-transplant cyclophosphamide. Bone Marrow Transplant 52, 135–137 (2017). https://doi.org/10.1038/bmt.2016.193

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