The Korean journal of internal medicine

  • 제30권2호
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  • Pages.212-218
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  • 2015
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  • 1226-3303(pISSN)
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  • 2005-6648(eISSN)
대한내과학회 (The Korean Association of Internal Medicine)
권호 표지
DOI QR코드

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Treatment of BK virus-associated hemorrhagic cystitis with low-dose intravenous cidofovir in patients undergoing allogeneic hematopoietic cell transplantation

  • Lee, Seung-Shin (Department of Hematology and Oncology, Chonnam National University Hwasun Hospital) ;
  • Ahn, Jae-Sook (Department of Hematology and Oncology, Chonnam National University Hwasun Hospital) ;
  • Jung, Sung-Hoon (Department of Hematology and Oncology, Chonnam National University Hwasun Hospital) ;
  • Ahn, Seo-Yeon (Department of Hematology and Oncology, Chonnam National University Hwasun Hospital) ;
  • Kim, Jae-Yong (Department of Hematology and Oncology, Chonnam National University Hwasun Hospital) ;
  • Jang, Hee-Chang (Department of Infectious Disease, Chonnam National University Hwasun Hospital) ;
  • Kang, Seung-Ji (Department of Infectious Disease, Chonnam National University Hwasun Hospital) ;
  • Jang, Mi-Ok (Department of Infectious Disease, Chonnam National University Hwasun Hospital) ;
  • Yang, Deok-Hwan (Department of Hematology and Oncology, Chonnam National University Hwasun Hospital) ;
  • Kim, Yeo-Kyeoung (Department of Hematology and Oncology, Chonnam National University Hwasun Hospital) ;
  • Lee, Je-Jung (Department of Hematology and Oncology, Chonnam National University Hwasun Hospital) ;
  • Kim, Hyeoung-Joon (Department of Hematology and Oncology, Chonnam National University Hwasun Hospital)
  • 투고 : 2014.03.18
  • 심사 : 2014.07.07
  • 발행 : 2015.03.01
⟨ 이전 논문 다음 논문 ⟩

초록

Background/Aims: BK virus (BKV) has been associated with late-onset hemorrhagic cystitis (HC) in recipients of hematopoietic stem cell transplantation (HSCT). Cidofovir has been used at higher doses (3 to 5 mg/kg/wk) with probenecid prophylaxis; however, cidofovir may result in nephrotoxicity or cytopenia at high doses. Methods: Allogeneic HSCT recipients with BKV-associated HC are treated with 1 mg/kg intravenous cidofovir weekly at our institution. A microbiological response was defined as at least a one log reduction in urinary BKV viral load, and a clinical response was defined as improvement in symptoms and stability or reduction in cystitis grade. Results: Eight patients received a median of 4 weekly (range, 2 to 11) doses of cidofovir. HC occurred a median 69 days (range, 16 to 311) after allogeneic HSCT. A clinical response was detected in 7/8 patients (86%), and 4/5 (80%) had a measurable microbiological response. One patient died of uncontrolled graft-versus-host disease; therefore, we could not measure the clinical response to HC treatment. One microbiological non-responder had a stable BKV viral load with clinical improvement. Only three patients showed transient grade 2 serum creatinine toxicities, which resolved after completion of concomitant calcineurin inhibitor treatment. Conclusions: Weekly intravenous low-dose cidofovir without probenecid appears to be a safe and effective treatment option for patients with BKV-associated HC.

키워드

참고문헌

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피인용 문헌

  1. Infectious complications after hematopoietic stem cell transplantation: current status and future perspectives in Korea vol.33, pp.2, 2015, https://doi.org/10.3904/kjim.2018.036
  2. Severe hemorrhagic cystitis caused by the BK polyomavirus is associated with decreased survival post‐allogeneic hematopoietic stem cell transplantation vol.21, pp.5, 2015, https://doi.org/10.1111/tid.13101
  3. Effects and long‐term follow‐up of using umbilical cord blood–derived mesenchymal stromal cells in pediatric patients with severe BK virus‐associated late‐onset hemorrhag vol.24, pp.2, 2020, https://doi.org/10.1111/petr.13618
  4. Imaging of acute abdomen in cancer patients vol.45, pp.8, 2015, https://doi.org/10.1007/s00261-019-02332-5
  5. Review of Intravesicular Cidofovir for BK Virus Hemorrhagic Cystitis vol.13, pp.3, 2015, https://doi.org/10.1007/s40506-021-00251-y
  6. Antivirals against human polyomaviruses: Leaving no stone unturned vol.31, pp.6, 2015, https://doi.org/10.1002/rmv.2220
  7. Safety and efficacy of intravenously administered cidofovir in adult haematopoietic cell transplant recipients: a retrospective multicentre cohort study vol.76, pp.11, 2021, https://doi.org/10.1093/jac/dkab259