异基因造血干细胞移植后并发出血性膀胱炎的危险因素分析

目的:分析异基因造血干细胞移植(allo-HSCT)后并发出血性膀胱炎(HC)的危险因素.方法:回顾性分析2010年1月-2018年12月于西安交通大学第一附属医院行allo-HSCT的153例患者的临床资料.观察HC的发生率、发生中位时间及治疗转归.利用多因素分析观察患者性别、年龄、诊断、移植前疾病状态、移植类型、预...

Analysis of the Risk Factors for He morrhagic Cystitis after Hematopoietic Stem Cell Transplantation

Objective:To analyze the risk factors affecting hemorrhagic cystitis(HC)after allogeneic hematopoietic stem cell transplantation(allo-HSCT).Methods:The clinical data of 153 patients underwent allogeneic hematopoietic stem cell transplantation in the First Affiliated Hospital of Xi’an Jiaotong University from January 2010 to December 2018 were selected and retrospectively analyzed.The incidence,median time and treatment outcome of HC should be observed.Multivariate analysis was used to observe the risk factors of HC in patients,including sex,age,diagnosis,disease status before transplantation,transplantation type,ATG and CTX in the pretreatment scheme,stem cell source,neutrophil and platelet implantation time;CMV,EBV and BKV infection,and acute graft-versus-host disease(aGVHD).Results:Among 153 patients underwent allogeneic hematopoietic stem cell transplantation,25(16.34%)patients had HC,the median occurance time was 31 days,all patients achieved complete remission after treatment,no bladder irritation and bladder contracture were left.The results of univariate and multivariate Logistic regression analysis showed that the type of transplantation,ATG,CMV viremia before treatment,aGVHD(r=1.036,3.234,3.298 and2.817,respectively)were the independent risk factors of HC.Conclusion:The urinary BKV detections in the patients with HC are positive,mainly occured during the period from day+13 to days+56.HLA haplotype,pretreatment including ATG,and CMV viremia,and aGVHD are the independent risk factors for HC after allo-HSCT.