ECIL guidelines for the prevention, diagnosis and treatment of BK polyomavirus-associated haemorrhagic cystitis in haematopoietic stem cell transplant recipients

Cesaro S, Dalianis T, Rinaldo CH, Koskenvuo M, Pegoraro A, Einsele H, Cordonnier C, Hirsch HH (2018)

Publication Type: Journal article

Publication year: 2018

Journal

Journal of Antimicrobial Chemotherapy Oxford University Press

Book Volume: 73

Pages Range: 12-21

Article Number: dkx324

Journal Issue: 1

DOI: 10.1093/jac/dkx324

Abstract

Objectives: To define guidelines for BK polyomavirus (BKPyV)-associated haemorrhagic cystitis (BKPyV-HC) after paediatric and adult HSCT. Methods: Review of English literature and evidence-based recommendations by expert consensus. Results: BKPyV-HC occurs in 8%-25%of paediatric and 7%-54%of adult recipients undergoing allogeneic HSCT. Diagnosis requires the triad of cystitis, macro-haematuria and high urine BKPyV loads > 7 log10 copies/mL, and exclusion of other relevant aetiologies. BKPyV viraemia is frequent and may serve as a more specific semiquantitative follow-up marker. No randomized controlled trials are available to inform antiviral prophylaxis or treatment. However, hyper-hydration and/or bladder irrigation showed limited prophylactic value. Fluoroquinolones are not effective for prophylaxis or treatment, but rather increase antibiotic resistance. Hyperbaric oxygen or fibrin glue is marginally effective based on small case series from correspondingly equipped centres. Although cidofovir has been reported to improve and/or reduce BKPyV viraemia or viruria, the current data do not support its regular use. Conclusions: BKPyV-HC remains a disabling unmet clinical need in HSCT that requires novel approaches supported by proper clinical trials.

Involved external institutions

University Hospital of Verona / Azienda Ospedaliera Universitaria Integrata Verona (AOUI) IT Italy (IT) Karolinska Institute SE Sweden (SE) University Hospital of North Norway / Universitetssykehuset Nord-Norge (UNN) NO Norway (NO) Helsingin yliopisto / University of Helsinki FI Finland (FI) Julius-Maximilians-Universität Würzburg DE Germany (DE) Paris-Est Créteil University / Université Paris-Est Créteil Val-de-Marne (UPEC) / Université Paris XII-Val-de-Marne / University Paris 12 Marne la Vallée FR France (FR) Universität Basel CH Switzerland (CH)

How to cite

APA:

Cesaro, S., Dalianis, T., Rinaldo, C.H., Koskenvuo, M., Pegoraro, A., Einsele, H.,... Hirsch, H.H. (2018). ECIL guidelines for the prevention, diagnosis and treatment of BK polyomavirus-associated haemorrhagic cystitis in haematopoietic stem cell transplant recipients. Journal of Antimicrobial Chemotherapy, 73(1), 12-21. https://doi.org/10.1093/jac/dkx324

MLA:

Cesaro, Simone, et al. "ECIL guidelines for the prevention, diagnosis and treatment of BK polyomavirus-associated haemorrhagic cystitis in haematopoietic stem cell transplant recipients." Journal of Antimicrobial Chemotherapy 73.1 (2018): 12-21.

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