The Risk Factors Of Hemorrhagic Cystitis After Allogen Eic Hematopoietic Stem Cell Transplantation

Objective:To investigate the risk factors for hemorrhagic cystitis(H C)after allogeneic hematopoietic stem cell transplantation(allo-HSCT).Methods: There are 149 patients were treated with allo-HSCT in t he department of hematology of the Second Hospital of Hebei Medical University on January 1,2014 and September 30,2018 were selected.T he clinical data of 134 patients who were available for analysis were re trospectively analyzed,starting from the date of pretreatment and follow ed up to 100 days after transplantation.Analysis of parameters that may affect the incidence and severity of HC after transplantation,including ag e,gender,pre-transplant diagnosis,pre-transplant disease status,does the conditioning regimencontain busulfan,cyclophosphamide,TBI,ATG/ATG-F,transplantation methods,gender compatibility of recipients,HLA matchin g,whether aGVHD,granulocyte and platelet implantation time,presence or absence blood CMV,BKV,JCV infection,urine CMV,BKV,JCV inf ection,whether hormones are applied before HC,HC occurrence time,HC duration,platelet count and coagulation when HC occurs.Using spss25.0 statistical software,the measurement data obeyed the normal distrib ution using(?x±s),the t-test was used for comparison between groups,the skewness distribution using median(25%,75%),and the compariso n between groups using mann-whitney U test.The count data is represe nted by n(%),and the chi-square test is used for comparison between groups.If T<5 or sample size < 40,chi-square correction formula or Fi sher’s exact probability method were used for univariate analysis.The m eaningful parameters were brought into the logistic regression for multiv ariate analysis,and the difference was statistically significant at the test level p<0.05.Result:1.Of the 134 patients with allo-HSCT,36 patients had HC,the inc idence rate was 26.9%(36/134);16 patients with mild HC,the incidenc e rate was 11.9%(16/134),and 21 patients with severe HC,the inciden ce rate was 14.9%(20/134).The median time to onset of HC was 29 d ays(-3-61 days).Thirty-six patients had delayed hemorrhagic cystitis(97.2% 35/36)and one had early-onset hemorrhagic cystitis(2.8% 1/36).T he median duration of HC duration was 21 days(7-84 days).2.In 36 patients with hemorrhagic cystitis,univariate analysis found that HLA matching,aGVHD,blood CMV-DNA positive,urine CMV,BKV and JCV DNA positive were risk factors for HC.Multivariate an alysis found that aGVHD,blood CMV positive and urinary BKV positiv e were independent risk factors for HC.3.For the severity of HC,univariate analysis found that aGVHD,B KV-DNA positive and HC disease duration after transplantation were the influencing factors of HC severity.Multivariate analysis found that aG VHD was an independent influencing factor affecting the severity of H C.Conclusion:The persistence of aGVHD after transplantation,blood CMV positive,and urinary BKV positive were independent risk factors for HC.The occurrence of aGVHD and HC duration are independent in fluencing factors affecting the severity of HC.After transplantation,aGV HD,blood CMV-DNA positive,and urinary BKV-DNA positive were in dependent risk factors for HC.The persistence of aGVHD after transpla ntation was an independent factors affecting HC severity.