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Cidofovir for BK Virus-Associated Hemorrhagic Cystitis: A Retrospective Study

Cesaro, Simone; Hirsch, Hans H.; Faraci, Maura; Owoc-Lempach, Joanna; Beltrame, Angela; Tendas, Andrea; Baltadakis, Ioannis; Dalle, Jean-Hughes; Koc, Yener and Toporski, Jacek LU , et al. (2009) In Clinical Infectious Diseases 49(2). p.233-240
Abstract
Background. BK virus-associated hemorrhagic cystitis (BKV-HC) is a severe complication after allogeneic hematopoietic stem cell transplantation (HSCT), but antiviral treatment for this condition has not been evaluated. Methods. We conducted a retrospective survey on the safety and outcome of cidofovir treatment for patients with BKV-HC in centers affiliated with the European Group for Blood and Marrow Transplantation. Results. From 1 April 2004 to 31 December 2007, 62 patients received a diagnosis of BKV-HC after a median interval of 35 days after HSCT (range, 3-577 days). Fifty-seven patients (92%) received intravenous cidofovir, whereas 5 patients received cidofovir intravesically. Complete response (CR) was recorded in 38 (67%) of 57... (More)
Background. BK virus-associated hemorrhagic cystitis (BKV-HC) is a severe complication after allogeneic hematopoietic stem cell transplantation (HSCT), but antiviral treatment for this condition has not been evaluated. Methods. We conducted a retrospective survey on the safety and outcome of cidofovir treatment for patients with BKV-HC in centers affiliated with the European Group for Blood and Marrow Transplantation. Results. From 1 April 2004 to 31 December 2007, 62 patients received a diagnosis of BKV-HC after a median interval of 35 days after HSCT (range, 3-577 days). Fifty-seven patients (92%) received intravenous cidofovir, whereas 5 patients received cidofovir intravesically. Complete response (CR) was recorded in 38 (67%) of 57 patients with HC treated with intravenous cidofovir, whereas partial response (PR) was documented in 7 patients (12%). CR was documented in 3 patients and PR in 1 patient with HC treated with intravesical cidofovir. A reduction of 1-3 logs in BKV load was documented in 8 of the 10 patients achieving CR. Mild-to-moderate toxic effects were recorded in 18 of 57 patients who received intravenous cidofovir administration. In a multivariate analysis, the factors significantly associated with response to cidofovir were the stem cell source (Pp. 01) and the use of total body irradiation (P = .03). After a median follow-up of 287 days, overall survival and total treatment-related mortality rates were 63% and 40% for patients achieving CR, compared with 14% and 72% for patients with PR or no response to cidofovir, respectively (P < .001 and P = .001, respectively). Conclusions. Cidofovir may be a potentially effective therapy for BKV-HC, but evidence supporting its use requires randomized controlled trials. (Less)
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Clinical Infectious Diseases
volume
49
issue
2
pages
233 - 240
publisher
The Infectious Diseases Society of America
external identifiers
  • wos:000267226900012
  • scopus:67651091353
ISSN
1537-6591
DOI
10.1086/599829
language
English
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yes
id
4fd697e1-3796-494a-8172-9dbef9de3b03 (old id 1441483)
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2009-07-28 08:47:13
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2017-11-12 03:30:00
@article{4fd697e1-3796-494a-8172-9dbef9de3b03,
  abstract     = {Background. BK virus-associated hemorrhagic cystitis (BKV-HC) is a severe complication after allogeneic hematopoietic stem cell transplantation (HSCT), but antiviral treatment for this condition has not been evaluated. Methods. We conducted a retrospective survey on the safety and outcome of cidofovir treatment for patients with BKV-HC in centers affiliated with the European Group for Blood and Marrow Transplantation. Results. From 1 April 2004 to 31 December 2007, 62 patients received a diagnosis of BKV-HC after a median interval of 35 days after HSCT (range, 3-577 days). Fifty-seven patients (92%) received intravenous cidofovir, whereas 5 patients received cidofovir intravesically. Complete response (CR) was recorded in 38 (67%) of 57 patients with HC treated with intravenous cidofovir, whereas partial response (PR) was documented in 7 patients (12%). CR was documented in 3 patients and PR in 1 patient with HC treated with intravesical cidofovir. A reduction of 1-3 logs in BKV load was documented in 8 of the 10 patients achieving CR. Mild-to-moderate toxic effects were recorded in 18 of 57 patients who received intravenous cidofovir administration. In a multivariate analysis, the factors significantly associated with response to cidofovir were the stem cell source (Pp. 01) and the use of total body irradiation (P = .03). After a median follow-up of 287 days, overall survival and total treatment-related mortality rates were 63% and 40% for patients achieving CR, compared with 14% and 72% for patients with PR or no response to cidofovir, respectively (P &lt; .001 and P = .001, respectively). Conclusions. Cidofovir may be a potentially effective therapy for BKV-HC, but evidence supporting its use requires randomized controlled trials.},
  author       = {Cesaro, Simone and Hirsch, Hans H. and Faraci, Maura and Owoc-Lempach, Joanna and Beltrame, Angela and Tendas, Andrea and Baltadakis, Ioannis and Dalle, Jean-Hughes and Koc, Yener and Toporski, Jacek and Styczynski, Jan and Yesilipek, M. Akif and Heinz, Werner and Caniglia, Maurizio and Rascon, Jelena and Fauser, Axel A. and Michallet, Mauricette and Lopez-Corral, Lucia and Neuburger, Stefan and Tridello, Gloria and Einsele, Herman},
  issn         = {1537-6591},
  language     = {eng},
  number       = {2},
  pages        = {233--240},
  publisher    = {The Infectious Diseases Society of America},
  series       = {Clinical Infectious Diseases},
  title        = {Cidofovir for BK Virus-Associated Hemorrhagic Cystitis: A Retrospective Study},
  url          = {http://dx.doi.org/10.1086/599829},
  volume       = {49},
  year         = {2009},
}