CT-230 Evaluation of BK Polyomavirus Infection Frequency and Risk Factors Following Allogeneic Stem Cell Transplantation (allo-SCT): A Single Center Experience

• Published in: Clinical lymphoma, myeloma and leukemia Vol. 23; p. S523
• Main Authors: Gezici, Barış, Soyer, Nur Akad, Güneş, Ajda Ersoy, Saydam, Güray, Töbü, Mahmut, Şahin, Fahri, Vural, Filiz
• Format: Journal Article
• Language: English
• Published: Elsevier Inc 01-09-2023
• Subjects: allogeneic stem cell transplantation; hemorrhagic cystitis; myeloablative; risk factors; risk factors; allogeneic stem cell transplantation; hemorrhagic cystitis; myeloablative
• ISSN: 2152-2650; 2152-2669
• DOI: 10.1016/S2152-2650(23)01500-8

Hemorrhagic cystitis (HC) is a clinical entity that mostly occurs after allo-SCT and reduces the quality of life of patients, prolongs hospitalization and increases the financial burden of treatment. While the main reason for early-onset HC is the toxicity of the conditioning regimen, BK polyomavirus (BKV) is the main cause in late-onset HC. BKV-associated hemorrhagic cystitis (BKV-HC) also draws attention due to the lack of a definitive treatment agreed in the literature. In this study, it was aimed to investigate frequency and risk factors of BKV-HC development.
Overall, 221 adult patients who underwent first allo-SCT between 2012 and 2020 at our institution were included in this single center, retrospective, observational study. Data on patients’ sociodemographic information, characteristics of the allo-SCT procedure and complications, donor characteristics, and parameters related to BKV-HC were collected.
The mean follow-up period was 1067.4 days. Matched related donors in 166 (75.1%), matched unrelated donors in 47 (21.3%) and haploidentic donors in 8 (3.6%) transplants were used. Of the conditioning regimens used in transplants, 167 (75.6%) were myeloablative, 36 (16.3%) were reduced-intensity and 18 (8.1%) were nonmyeloablative. The mean engraftment time was 17.9 days. aGVHD, cGVHD, BKV-HC occured in 86 (38.9%), 44 (23%), 17 (7.7%) of the patients included in the study, respectively. Use of myeloablative conditioning regimen (P=0.047), development of cytomegalovirus (CMV) infection (P=0.02) and history of CMV infection prior to allo-SCT (P=0.009) were determined as risk factors for the development of BKV-HC. No correlation was observed between the severity of BKV-HC and peak BKV DNA in urine.
In our study, frequency and risk factors of BKV-HC were determined. Reporting of development of CMV infection and a positive history of CMV infection prior to allo-SCT as risk factors for development of BKV-HC was especially significant. The results suggest that in patients with a history of CMV infection prior to allo-SCT, avoidance of other factors that may increase the risk of BKV-HC, such as the use of a myeloablative conditioning regimen, may be preferred.