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European Congress of Clinical Microbiology and Infectious Diseases 2020, Paris, France, 17 April 2020, pp.499-500, (Summary Text)
Risk factors and clinical characteristics of virus Infection after haematopoietic stem cell transplantation Gamze Kalın Ünüvar*1, Zeynep Ture Yuce1, Aysegül Ulu Kilic2 1University Of Erciyes Faculty Of Medicine, Kayseri, Turkey, 1University Of Erciyes Faculty Of Medicine, Kayseri, Turkey Background: BK polyomavirus is an important cause of morbidity and mortality in hematological patients after hematopoietic stem cell transplantation (HSCT). It is acquired in childhood and especially becomes latent in urothelial epithelial cells. Reactivation of virus after HSCT can be seen with asymptomatic viruria or hemorrhagic cystitis (HC). The aim of the study was to assess risk factors, clinical characteristics and treatment options of BK virus infection after HSCT. Materials/methods: We retrospectively analyzed information about patients with HSCT and BK virus (BKV) disease between January 2017-August 2019. Data included; underlying hematological disease, transplantation type, associated graft versus host disease (GVHD) and recent use of immunosuppressive agent. Results: In total fifty-eight patients with HSCT were evaluated and BKV disease occurred in 20 (34%). The median age was 40 (range, 20 to 68), 50% were male. The most underlying disease was Acute Myeloid Leukemia (n=11). Five patients had autologous and fifteen patients had allogeneic SCT. The median time to engraftment was 15 days (range, 10 to 20). GVHD was seen eleven patients (40% skin, 15% gastrointestinal GVHD). These patients received systemic glucocorticoid therapy or immunosuppressant agents. The median time elapsed to BK virus disease after HSCT was 60 days (range, 30 to 450). Sixteen patients with BKV disease had high grade (grade 3) HC and four patients had low-grade HC (grade 2). While BK viremia was positive in 17 patients (68%), viruria was positive for all patients. Eight patients (15%) were treated with ciprofloxacin and cidofovir combination, six patients (30%) with cidofovir and three patients (15%) with ciprofloxacin. Three of them (20 patients) was treated by intravesical cidofovir. The complete response to the viruria or viremia was obtained from 11 patients (55%). Conclusions: HC associated with BKV is an emerging clinical problem after HSCT causing prolonged hospitalization and mortality. It can be severe because the treatment options are often ineffective. The main goal of treatment is to reduce the dose of immunosuppressive agents. Close monitoring of BK virus in high-risk patients can be an important method to improve the complication in the early period.