Objective: To analyze the etiology and clinical features of late onset hemorrhagic cystitis (LOHC) after allogeneic hematopoietic stem cell transplantation (HSCT).
Methods: The medical records of 200 patients undergoing allogeneic HSCT from 2004 to 2005 were analyzed retrospectively.
Results: HC developed in 57 patients within 180 days after the transplantation with a cumulative incidence of 28.8%. The etiology of 31 patients (54.39%) was infection, caused by infection of cytomegalovirus (CMV) or adenovirus and cured by anti-virus therapy, thus the cause of disease could be classified as infection agent. Viremia was seen in 12 patients (21.53%) with CMV and disappeared in urine after anti-virus therapy but bleeding still persisted. For these patients the cause of disease was classified as infection agent combined with non-infection factor. Evidence of infection agent could not be discovered in 14 patients (24.56%) and they failed to respond to anti-infection therapy. For them the cause of disease was classified as non-infection agent. 13 patients with refractory HC underwent tentative treatment with corticosteroids, 9 of them achieved a complete remission, 2 of them achieved partial remission, and 2 of them remained non-responsive.
Conclusion: LOHC after allo-HSCT is a common complication and caused by multiple factors. Differentiation of the possible causes may benefit its clinical outcome.