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BK Virus Epidemiology, Risk Factors, and Clinical Outcomes: An Analysis of Hematopoietic Stem Cell Transplant Patients at Texas Children's Hospital.
- Source :
-
Journal of the Pediatric Infectious Diseases Society . Apr2021, Vol. 10 Issue 4, p492-501. 10p. - Publication Year :
- 2021
-
Abstract
- Background BK virus-associated hemorrhagic cystitis (BKV-HC) is a serious complication after hematopoietic stem cell transplantation (HSCT). Methods A retrospective review was performed to determine the frequency of BKV-HC and identify risk factors and renal morbidity associated with BKV-HC in pediatric HSCT recipients at our institution. Results A total of 314 pediatric recipients underwent allogeneic HSCT for either malignant (173, 55.1%) or nonmalignant disorders (141, 44.9%) from January 1, 2011, to December 31, 2015, with a minimum follow-up of 5 years post-HSCT. Severe BKV-HC (grades 3 and 4) was prevalent in 46 out of 67 (68.7%) recipients. Timing to presentation of severe BKV-HC (grades 3 and 4) occurred at a median of 37 days (26, 74; IQ1, IQ3) post-HSCT, with the duration of macroscopic hematuria lasting a median of 37.5 days (18, 71; IQ1, IQ3). In the first 60 days post-HSCT, peak acute kidney injury (AKI) stages 2 and 3 were seen more frequently in HSCT recipients who developed BKV-HC than those without (P =.004). Similarly, during post-HSCT days 61 to 100, peak AKI stage 3 was also more frequently seen in HSCT recipients who already developed BKV-HC prior to or during this time period than those without BKV-HC (P =.0002). Recipients who developed BKV-HC within 1 year of HSCT had more frequent mild to moderate chronic kidney disease (CKD stages 2-3) than those without BKV-HC (P =.002 and.007, respectively). On multivariate analysis, BKV-HC was associated with all-cause mortality (hazard ratio [HR]: 2.22; 95% confidence interval [CI]: 1.35-3.65). The following clinical variables were associated with time to development of HC on multivariate analysis: age (subdistribution HR [sHR] 1.11; 95% CI: 1.06-1.16) and myeloabalative conditioning regimen (sHR 4.2; 95% CI: 2.12-8.34). Conclusions Pediatric HSCT patients with BKV-HC experience significant morbidity and mortality. Renal morbidity, including AKI and CKD, is associated with BKV-HC. [ABSTRACT FROM AUTHOR]
- Subjects :
- *HEMORRHAGIC diseases
*EVALUATION of medical care
*POLYOMAVIRUS diseases
*CHRONIC kidney failure
*ACQUISITION of data methodology
*CONFIDENCE intervals
*CYSTITIS
*TIME
*MULTIVARIATE analysis
*RETROSPECTIVE studies
*RISK assessment
*MEDICAL records
*DESCRIPTIVE statistics
*HEMATOPOIETIC stem cell transplantation
*ACUTE kidney failure
*TRANSPLANTATION of organs, tissues, etc.
*DISEASE risk factors
*EVALUATION
*DISEASE complications
*CHILDREN
Subjects
Details
- Language :
- English
- ISSN :
- 20487193
- Volume :
- 10
- Issue :
- 4
- Database :
- Academic Search Index
- Journal :
- Journal of the Pediatric Infectious Diseases Society
- Publication Type :
- Academic Journal
- Accession number :
- 150595509
- Full Text :
- https://doi.org/10.1093/jpids/piaa147