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Intravesical application of platelet-rich plasma in patients with persistent haemorrhagic cystitis after hematopoietic stem cell transplantation: a single-centre preliminary experience

  • Urology - Original Paper
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Abstract

Purpose

Haemorrhagic cystitis (HC) after allogeneic transplantation (HSCT) is a condition characterized by diffuse inflammation and bleeding from the bladder mucosa. Treatment of HC is not standardized and clinical Guidelines are elusive. The aim of this study was to evaluate the safety and efficacy of intravesical treatment with platelet-rich plasma (PRP) in patients with HC after allogenic HSCT.

Methods

Data from ten consecutive patients with BK virus-induced HC between 2013 and 2017 were collected. HC was classified into four grades. Inclusion criteria were (a) grade 3 or 4 BKV-induced HC after allogenic HSCT; (b) HC refractory to conservative therapy. All patients underwent transurethral cystoscopy and PRP treatment under general anaesthesia.

Results

Mean patients’ age was 33.6 years. Four patients (40%) presented a grade 3 BKV-induced HC and six patients (60%) a grade 4. No intraoperative complications occurred. Postoperative complications were recorded in six patients: three patients required blood transfusion while three patients endovenous antibiotic therapy. Median time to catheter removal was 6 days (IQR 2–10). Median length of hospitalization was 35 days (IQR 6–73). At 30 days after surgery, a three-way catheter was repositioned in one patient for grade 4 haematuria, six patients had a complete response, and three a partial response.

Conclusions

Our preliminary experience suggests that intravesical administration of PRP should be considered as a feasible and safe option for the treatment of BK-induced HC after HSCT. Future studies are needed to assess its potential value in other forms of haemorrhagic cystitis.

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Acknowledgements

No financial support has been received for this research/study.

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Authors and Affiliations

  1. Department of Urology, Clinica Urologica I, Azienda Ospedaliera Careggi, Università di Firenze, Viale San Luca, 50134, Florence, Italy

    Lorenzo Masieri, Francesco Sessa, Andrea Mari, Riccardo Campi, Gianmartin Cito, Pierangelo Verrienti, Simone Sforza, Fabrizio Di Maida, Antonio Andrea Grosso, Marco Carini & Andrea Minervini

  2. Department of Haematology, University of Florence, Careggi Hospital, Florence, Italy

    Chiara Nozzoli & Riccardo Saccardi

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  1. Lorenzo Masieri
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  2. Francesco Sessa
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Correspondence to Francesco Sessa.

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Masieri, L., Sessa, F., Mari, A. et al. Intravesical application of platelet-rich plasma in patients with persistent haemorrhagic cystitis after hematopoietic stem cell transplantation: a single-centre preliminary experience. Int Urol Nephrol 51, 1715–1720 (2019). https://doi.org/10.1007/s11255-019-02223-0

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