748 RISK FACTORS FOR HEMORRHAGIC CYSTITIS AFTER BONE MARROW TRANSPLANTATION IN 849 CHILDREN

You have accessJournal of UrologyPediatrics: Bladder Dysfunction - Myelodysplasia, Voiding Dysfunction, Enuresis1 Apr 2010748 RISK FACTORS FOR HEMORRHAGIC CYSTITIS AFTER BONE MARROW TRANSPLANTATION IN 849 CHILDREN Cem Irkilata, Jodi Antonelli, Paul Martin, Jeremy Wiygul, and John Wiener Cem IrkilataCem Irkilata More articles by this author , Jodi AntonelliJodi Antonelli More articles by this author , Paul MartinPaul Martin More articles by this author , Jeremy WiygulJeremy Wiygul More articles by this author , and John WienerJohn Wiener More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2010.02.1274AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Hemorrhagic cystitis (HC) is a well-known complication for patients undergoing bone marrow transplantation (BMT). We sought to identify factors associated with HC in pediatric patients undergoing BMT for benign and malignant diseases. METHODS After obtaining institutional review board approval, 849 children (age 4 days - 25 yrs, median 5.9 yrs) who underwent BMT between Jan. 1999 and Dec. 2008 at Duke University Medical Center were included in this study. HC was graded 1-4 (1= microscopic, 2= gross hematuria without clots, 3= gross hematuria with clots requiring transfusion, 4= gross hematuria that required surgery). Grades 3-4 were considered severe HC. Age at BMT, gender, race, underlying diagnosis, prior transplantation, BMT type (allogeneic vs autologous), source of BMT (peripheral blood, bone marrow, cord blood), and conditioning regimen were obtained by retrospective chart review. Univariate analyses were performed with t-test and chi-square and multivariate analyses were performed with multivariate logistic regression. RESULTS Clinically relevant HC was found in 120 patients: 76 (9%) had Grade 2 HC, 33 (4%) had Grade 3 HC, and 11 (1%) had Grade 4 HC. On univariate analysis, older age at BMT was a risk factor for development of Grades 2-4 HC (P<0.01) and severe HC (P<0.01). African-American race was strongly associated with Grades 2-4 HC (P<0.01) and severe HC (P<0.01). Additionally, a race designation of “other” was associated with severe HC (P<0.01). An underlying diagnosis of acute leukemia (P= 0.018) or lymphoma (P= 0.034) was associated with Grades 2-4 HC. A conditioning regimen that included cyclophosphamide (P= 0.047) was associated with severe HC, while those that included Etoposide (P= 0.022) and Carboplatin (P= 0.020) were associated with Grades 2-4 HC. On multivariate analysis older age was independently associated with Grade 2-4 HC (OR=1.09, P<=0.001) and severe HC (OR=1.08, P=0.004). African-American race was also independently associated with Grade 2-4 HC (OR=3.28, P<0.001) and severe HC (OR=7.51, P<0.001) while “other” race was associated with severe HC only (OR=4.31, P=0.001). CONCLUSIONS To our knowledge, this is the largest study of its kind. These results suggest that age at BMT, race, underlying diagnosis, and conditioning regimen are factors that can affect development of HC in pediatric BMT patients. Defining these risk factors may be an important step in determining the pathophysiology and developing preventative measures for this significant morbidity. Durham, NC© 2010 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 183Issue 4SApril 2010Page: e292-e293 Advertisement Copyright & Permissions© 2010 by American Urological Association Education and Research, Inc.MetricsAuthor Information Cem Irkilata More articles by this author Jodi Antonelli More articles by this author Paul Martin More articles by this author Jeremy Wiygul More articles by this author John Wiener More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...