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Revista Cubana de Hematología, Inmunología y Hemoterapia
versão On-line ISSN 1561-2996
Resumo
ROQUE GARCIA, Wilfredo; SARDUY SAEZ, Sandra; JAIME FAGUNDO, Juan Carlos e LEYVA PERDOMO, Yanitza. Hemorrhagic cystitis due to viral infection in patients who received hematopoietic haploidentical transplantation: two case reports. Rev Cubana Hematol Inmunol Hemoter [online]. 2020, vol.36, n.1 Epub 01-Jul-2020. ISSN 1561-2996.
Introduction:
Viral infections or latent-virus reactivation are frequent during the immunosuppressed cincition that follows hematopoietic stem-cell transplantation, and an important cause of complications, such as hemorrhagic cystitis, characterized by dysuria, urinary frequency, abdominal pain, and hematuria. The early appearance is associated with the administration of cytostatic drugs such as cyclophosphamide, and the late onset is associated with primary infection or reactivation of viruses such as cytomegalovirus, adenoviruses, or polyomaviruses such as BK and JC.
Objective:
To describe the clinical characteristics, evolution and management of post-transplant hemorrhagic cystitis.
Clinical cases:
The cases are presented of two patients with acute myeloid leukemia who developed hemorrhagic cystitis associated with viral infection by BK virus and cytomegalovirus after haploidentical transplantation with post-transplant cyclophosphamide. Viral hemorrhagic cystitis after hematopoietic transplantation in these patients was associated with severe immunosuppression, making it a potentially lethal complication. Both patients presented grade IV hemorrhagic cystitis and died despite treatment.
Conclusions:
Haploidentical transplantation with the of post-transplant cyclophosphamide administration increases the possibility for donors of hematopoietic progenitor cells to patients without an identical HLA match, but the higher level of immunosuppression could increase the incidence of viral hemorrhagic cystitis.
Palavras-chave : hemorrhagic cystitis; haploidentical transplant; cytomegalovirus; BK virus; JC virus.