Intravesical cidofovir to treat BK virus‐associated hemorrhagic cystitis in children after hematopoietic stem cell transplantation |
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| Authors: | Jelena Rascon Gilvydas Verkauskas Ramune Pasauliene Vytautas Zubka Vytautas Bilius Lina Rageliene |
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| Affiliation: | 1. Center of Pediatric Oncology and Hematology, Bone Marrow Transplantation unit, Children's Hospital, Affiliate of Vilnius University Hospital Santariskiu Klinikos, Vilnius, Lithuania;2. Vilnius University, Vilnius, Lithuania;3. Department of Pediatric Urology, Children's Hospital, Affiliate of Vilnius University Hospital Santariskiu Klinikos, Vilnius, Lithuania;4. Center of Pediatric Anesthesiology and Intensive Care, Children's Hospital, Affiliate of Vilnius University Hospital Santariskiu Klinikos, Vilnius, Lithuania |
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| Abstract: | HC related to BK virus replication might be a severe complication following allogeneic HSCT. There are no clearly defined treatment guidelines in pediatric population. The data on the effectiveness of ICI to manage severe bleeding in children are very limited. We report our experience of intravesical cidofovir in four children, 6–15 yr of age, to manage grade III–IV BK virus‐associated HC. Three of four children had high CSA serum level prior to developing cystitis. Intravesical instillations of cidofovir resulted only in temporal relief of bleeding. After immune suppression was withdrawn or tapered, intravesical instillations of formalin solution had to be undertaken to abort severe bleeding. We concluded that intravesical cidofovir alone did not appear to be sufficiently effective in case of severe HC, necessitating complimentary procedures to stop macrohematuria. |
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| Keywords: | hematopoietic stem cell transplantation hemorrhagic cystitis BK virus cidofovir intravesical instillation |
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