Successful hyperbaric oxygen therapy for refractory BK virus-associated hemorrhagic cystitis after cord blood transplantation

Transpl Infect Dis. 2014 Oct;16(5):843-6. doi: 10.1111/tid.12266. Epub 2014 Jul 12.

Abstract

BK virus-associated hemorrhagic cystitis (BKV-HC) is a common and major cause of morbidity in recipients of allogeneic hematopoietic stem cell transplantation. A 32-year-old woman developed severe BKV-HC on day 24 after cord blood transplantation (CBT). Despite supportive therapies - such as hyperhydration, forced diuresis, and urinary catheterization - macroscopic hematuria and bladder irritation persisted for over a month. Hyperbaric oxygen (HBO) therapy at 2.1 atmospheres for 90 min per day was started on day 64 after CBT. Macroscopic hematuria resolved within a week, and microscopic hematuria was no longer detectable within 2 weeks. Hematuria did not recur after 11 sessions of HBO therapy, and no significant side effects were observed during or after treatment. HBO therapy could thus be useful in controlling refractory BKV-HC after CBT.

Keywords: BK virus; BK virus-associated hemorrhagic cystitis; cord blood transplantation; hyperbaric oxygen therapy.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • BK Virus*
  • Cystitis / therapy*
  • Cystitis / virology
  • Female
  • Fetal Blood / transplantation*
  • Hematuria / therapy*
  • Hematuria / virology
  • Humans
  • Hyperbaric Oxygenation*
  • Polyomavirus Infections / complications*
  • Precursor Cell Lymphoblastic Leukemia-Lymphoma / therapy
  • Tumor Virus Infections / complications*