Outcomes and risk factors of hemorrhagic cystitis in pediatric allogeneic hematopoietic stem cell transplantation recipients using different graft source and condition with severe aplastic anemia
Bohan Li,
Lijun Meng,
Yuanyuan Tian,
Qin Lu,
Li Gao,
Peifang Xiao,
Jun Lu,
Jie Li,
Lin Wan,
Zhiheng Li,
Shaoyan Hu,
Lingjun Kong
Affiliations
Bohan Li
Department of Hematology, Children's Hospital of Soochow University, Suzhou, People’s Republic of China
Lijun Meng
Department of Hematology, Children's Hospital of Soochow University, Suzhou, People’s Republic of China
Yuanyuan Tian
Department of Hematology, Children's Hospital of Soochow University, Suzhou, People’s Republic of China
Qin Lu
Department of Hematology, Children's Hospital of Soochow University, Suzhou, People’s Republic of China
Li Gao
Department of Hematology, Children's Hospital of Soochow University, Suzhou, People’s Republic of China
Peifang Xiao
Department of Hematology, Children's Hospital of Soochow University, Suzhou, People’s Republic of China
Jun Lu
Department of Hematology, Children's Hospital of Soochow University, Suzhou, People’s Republic of China
Jie Li
Department of Hematology, Children's Hospital of Soochow University, Suzhou, People’s Republic of China
Lin Wan
Department of Hematology, Children's Hospital of Soochow University, Suzhou, People’s Republic of China
Zhiheng Li
Department of Hematology, Children's Hospital of Soochow University, Suzhou, People’s Republic of China
Shaoyan Hu
Department of Hematology, Children's Hospital of Soochow University, Suzhou, People’s Republic of China
Lingjun Kong
Department of Hematology, Children's Hospital of Soochow University, Suzhou, People’s Republic of China
Background Hemorrhagic cystitis (HC) is a severe complication of allo-HSCT, characterized by irritative symptoms of the urinary tract and a higher morbidity rate. The risk factors and prognosis of HC are still unclear.Objective The objective of this study is to identify risk factors and outcomes to improve treatment in pediatric SAA patients undergoing HSCTs in the Children's Hospital of Soochow University.Methods A total of 97 SAA patients as a cohort were enrolled from 2010 to 2019 in the Children's Hospital of Soochow University and a number of factors related to HC and outcomes were analysed. In all transplants (except UCBT), patients received a combination of G-CSF stimulated bone marrow (BM) and peripheral blood stem cell (PBSC). The minimum number of CD34 + cells is 5 × 106 cells/kg.Results Mononuclear cells dose (MNC, cut off: 8.53 × 108/kg) and grade II–IV acute graft versus host disease (aGVHD) were identified as independent risk factors for HC. Patients without HC had better overall survival (OS) than with HC (No HC: 98.6%±1.4% vs HC: 87.4% ± 6.8%, p = 0.03).Conclusion We concluded that aGVHD and MNC dose in graft might play an important role in the development of HC in pediatric SAA patients undergoing allo-HSCT. HC is also a key complication affecting the prognosis of children with SAA after allo-HSCT.
