TY - JOUR
T1 - ECIL guidelines for the prevention, diagnosis and treatment of BK polyomavirus-associated haemorrhagic cystitis in haematopoietic stem cell transplant recipients
AU - On behalf of the 6th European Conference on, Infections in Leukaemia (ECIL-6), A joint venture of the Infectious Diseases Working Party of the European Group for Blood and Marrow Transplantation (EBMT-IDWP), the Infectious Diseases Group of the European O
AU - Cesaro, Simone
AU - Dalianis, Tina
AU - Rinaldo, Christine Hanssen
AU - Koskenvuo, Minna
AU - Pegoraro, Anna
AU - Einsele, Hermann
AU - Cordonnier, Catherine
AU - Hirsch, Hans H.
AU - Akova, Murat
AU - Aljurf, Mahmoud
AU - Averbuch, Dina
AU - Barnes, Rosemary
AU - Blennow, Ola
AU - Bochud, Pierre Yves
AU - Bouza, Emilio
AU - Bretagne, Stephane
AU - Brüggemann, Roger
AU - Calandra, Thierry
AU - Carratala, Jordi
AU - Cornely, Oliver
AU - de la Camara, Rafael
AU - Donnelly, Peter
AU - Drgona, Lubos
AU - Duarte, Rafael
AU - Engelhard, Dan
AU - Fox, Christopher
AU - Girmenia, Corrado
AU - Groll, Andreas
AU - Heldal, Dag
AU - Helweg-Larsen, Jannick
AU - Herbrecht, Raoul
AU - Johnson, Elisabeth
AU - Klyasova, Galina
AU - Lagrou, Katrien
AU - Lewis, Russell E.
AU - Ljungman, Per
AU - Maertens, Johan
AU - Mikulska, Malgorzata
AU - Nucci, Marcio
AU - Padoin, Christophe
AU - Pagano, Livio
AU - Pagliuca, Antonio
AU - Racil, Zdenek
AU - Ribaud, Patricia
AU - Rizzi-Puechal, Valérie
AU - Roilides, Emmanuel
AU - Robin, Christine
AU - Rovira, Montserrat
AU - Rupp, Markus
AU - Sanchez, Sonia
N1 - Publisher Copyright:
© The Author 2017. Published by Oxford University Press on behalf of the British Society for Antimicrobial Chemotherapy. All rights reserved.
PY - 2018/1/1
Y1 - 2018/1/1
N2 - 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.
AB - 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.
UR - http://www.scopus.com/inward/record.url?scp=85040622996&partnerID=8YFLogxK
U2 - 10.1093/jac/dkx324
DO - 10.1093/jac/dkx324
M3 - Article
C2 - 29190347
AN - SCOPUS:85040622996
SN - 0305-7453
VL - 73
SP - 12
EP - 21
JO - Journal of Antimicrobial Chemotherapy
JF - Journal of Antimicrobial Chemotherapy
IS - 1
M1 - dkx324
ER -
