Conjugated Estrogen in Late-Onset Hemorrhagic Cystitis Associated with Hematopoietic Stem Cell Transplantation
-
Seyed Asadollah Mousavi
,
Vahid Moazed
,
Niayesh Mohebbi
,
Molouk Hadjibabaie
,
Kamran Alimoghaddam
,
Babak Bahar
,
Mohammad Jahani
,
Ardeshir Ghavamzadeh
Abstract
Background: Hemorrhagic cystitis (HC) is one of the most challenging complications in hematopoietic stem cell transplantation (HSCT). Estrogen is one of the suggested treatments for controlling this problem.
Subjects and Methods: We performed a randomized case-control study to evaluate the efficacy of oral conjugated estrogen on HC management in 56 HSCT patients. Patients were randomly assigned to the drug group (received 6.25 mg conjugated estrogen oral tablets in a daily single dose during hematuria period) or control group.
Result: The median time to complete response was 36 and 24 days in the drug and control group, respectively. The median time of down stage was 24 days in the drug group and 12 days in control group. Adjusted for HC grades, the relative risk of complete response for patients in control group was 1.613 times more than that of patients in drug group; nevertheless, not significant (p=0.122).
Conclusion: Our study did not show any benefit in use of oral conjugated estrogen in the management of HC.
Copelan EA. Hematopoietic stem-cell transplantation. N Engl J Med. 2006; 354(17):1813-26.
Ilhan O, Koc H, Akan H, et al. Hemorrhagic cystitis as a complication of bone marrow transplantation. J Chemother. 1997; 9(1):56-61.
Efros MD, Ahmed T, Coombe N, et al. Urologic complications of high-dose chemotherapy and bone marrow transplantation. Urology. 1994; 43(3):355-60.
Watson NA, Notley RG. Urological Complications of Cyclophosphamide. Br J Urol. 1973; 45(6):606-09.
Gorczynska E, Turkiewicz D, Rybka K, et al. Incidence, Clinical Outcome, and Management of Virus-Induced Hemorrhagic Cystitis in Children and Adolescents after Allogeneic Hematopoietic Cell Transplantation. Biol Blood Marrow Transplant. 2005; 11(10):797-804.
Cesaro S, Brugiolo A, Faraci M, et al. Incidence and treatment of hemorrhagic cystitis in children given hematopoietic stem cell transplantation: a survey from the Italian association of pediatric hematology oncology–bone marrow transplantation group. Bone Marrow Transplant. 2003; 32(9):925-31.
Leung AY, Yuen KY, Kwong YL. Polyoma BK virus and haemorrhagic cystitis in haematopoietic stem cell transplantation: a changing paradigm. Bone Marrow Transplant. 2005; 36(11):929-37.
Howard DS, Phillips GL, Reece DE, et al. Adenovirus infections in hematopoietic stem cell transplant recipients. Clin Infect Dis. 1999; 29(6):1494-1501.
Heath JA, Mishra S, Mitchell S, et al. Estrogen as treatment of hemorrhagic cystitis in children and adolescents undergoing bone marrow transplantation. Bone Marrow Transplant. 2006; 37(5):523-6.
Cheuk DK, Lee TL, Chiang AK, et al. Risk factors and treatment of hemorrhagic cystitis in children who underwent hematopoietic stem cell transplantation. Transpl Int. 2007; 20(1):73-81.
Mukamel E, Lupu A, DeKernion JB. Alum irrigation for severe bladder hemorrhage. J Urol. 1986; 135(4):784-5.
Trigg ME, O'Reilly J, Rumelhart S, et al. Prostaglandin E1 bladder instillations to control severe hemorrhagic cystitis. J Urol. 1990; 143(1):92-4.
Liu YK, Harty JI, Steinbock GS, et al. Treatment of radiation or cyclophosphamide induced hemorrhagic cystitis using conjugated estrogen. J Urol. 1990; 144(1):41-3.
Miller J, Burfield GD, Moretti KL. Oral conjugated estrogen therapy for treatment of hemorrhagic cystitis. J Urol. 1994; 151(5):1348-50.
Ordemann R, Naumann R, Geissler G, et al. Encouraging results in the treatment of haemorrhagic cystitis with estrogen–report of 10 cases and review of the literature. Bone Marrow Transplant. 2000; 25(9):981-5.
Brugieres L, Hartmann O, Travagli J, et al. Hemorrhagic cystitis following high-dose chemotherapy and bone marrow transplantation in children with malignancies: incidence, clinical course and outcome. J Clin Oncol. 1989; 7:194-9.
Lunde LE, Dasaraju S, Cao Q, et al. Hemorrhagic cystitis after allogeneic hematopoietic cell transplantation: risk factors, graft source and survival. Bone Marrow Transplant. 2015; 50(11):1432-7.
Shields AF, Hackman RC, Fife KH, et al. Adenovirus infections in patients undergoing bone-marrow transplantation. N Engl J Med. 1985; 312(9):529-33.
Ambinder RF, Burns W, Forman M, et al. Hemorrhagic cystitis associated with adenovirus infection in bone marrow transplantation. Arch Intern Med. 1986; 146(7):1400-1.
Miyamura K, Takeyama K, Kojima S, et al. Hemorrhagic cystitis associated with urinary excretion of adenovirus type 11 following allogeneic bone marrow transplantation. Bone Marrow Transplant. 1989; 4(5):533-5.
Arthur RR, Shah KV, Baust SJ, et al. Association of BK viruria with hemorrhagic cystitis in recipients of bone marrow transplants. N Engl J Med. 1986; 315(4):230-4.
Goldman RL, Warner NE. Hemorrhagic cystitis and cytomegalic inclusions in the bladder associated with cyclophosphamide therapy. Cancer. 1970; 25(1):7-11.
Trotman J, Nivison-Smith I, Dodds A. Haemorrhagic cystitis: incidence and risk factors in a transplant population using hyperhydration. Bone Marrow Transplant. 1999; 23(8):797-801.
Donahue LA, Frank IN. Intravesical formalin for hemorrhagic cystitis: analysis of therapy. J Urol. 1989; 141(4):809-12.
Susan LP, Marsh RJ. Phenolization of bladder in treatment of massive intractable hematuria. Urology. 1975; 5(1):119-21.
Vela-Ojeda J, Tripp-Villanueva F, Sanchez-Cortes E, et al. Intravesical rhGM-CSF for the treatment of late onset hemorrhagic cystitis after bone marrow transplant. Bone Marrow Transplant. 1999; 24(12):.1307-10.
Miodosky M, Abdul-Hai A, Tsirigotis P, et al. Treatment of post-hematopoietic stem cell transplantation hemorrhagic cystitis with intravesicular sodium hyaluronate. Bone marrow transplantation 2006; 38(7):507-11.
Levine LA, Jarrard DF. Treatment of cyclophosphamide-induced hemorrhagic cystitis with intravesical carboprost tromethamine. J Urol. 1993; 149(4):719-23.
Daly E, Vessey MP, Hawkins MM, et al. Risk of venous thromboembolism in users of hormone replacement therapy. Lancet. 1996; 348(9033):977-80.
| Files | ||
| Issue | Vol 11, No 1 (2017) | |
| Section | Articles | |
| Keywords | ||
| Conjugated estrogen Late-onset hemorrhagic cystitis Hematopoietic stem cell transplantation | ||
| Rights and permissions | |
|
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License. |
