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Transplant Proc ; 42(9): 3729-34, 2010 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-21094847

RESUMO

Late-onset hemorrhagic cystitis (HC) caused by adenovirus (AdV) infection is a common complication in hematopoietic stem cell transplantation (HSCT) recipients. However, limited information exists regarding adenovirus-associated HC. We report a retrospective study of 84 hematopoietic stem cell transplant recipients that evaluated the incidence and risk factors for AdV-induced HC. The development of HC was strongly related to adenoviral infection (P = .004). Among 13 patients who developed late-onset HC, AdVs were identified as a causative agent in 10 cases. AdV preferentially affected younger (P = .013) and male patients. Affected subjects had been transplanted for either malignant (7/10) or nonmalignant disorders (3/10). Most cases of AdV-hematuria were self-limited single or recurrent mild hemorrhagic episodes (P = .000), occurring at a median of 41 days after transplantation and lasting an average of 4 days. Viral load in patients with AdV-induced HC was similar to infected subjects who did not develop HC (2.5 × 10(3) vs 3.4 × 10(3) copies/mL). We HC occurring before 200 days was associated with a greater risk of a fatal outcome (P = .002) but occurrence of AdV infection did not affect a patient's survival. Our study confirmed the suggestion that non-AdV coinfections may worsen the course of AdV-HC.


Assuntos
Infecções por Adenoviridae/virologia , Adenoviridae/isolamento & purificação , Transplante de Medula Óssea/efeitos adversos , Cistite/virologia , Transplante de Células-Tronco Hematopoéticas/efeitos adversos , Hematúria/virologia , Hemorragia/virologia , Adenoviridae/genética , Infecções por Adenoviridae/diagnóstico , Infecções por Adenoviridae/mortalidade , Adolescente , Adulto , Transplante de Medula Óssea/mortalidade , Distribuição de Qui-Quadrado , Criança , Pré-Escolar , Cistite/mortalidade , DNA Viral/isolamento & purificação , Feminino , Transplante de Células-Tronco Hematopoéticas/mortalidade , Hematúria/mortalidade , Hemorragia/mortalidade , Humanos , Incidência , Lactente , Estimativa de Kaplan-Meier , Masculino , Polônia , Reação em Cadeia da Polimerase , Modelos de Riscos Proporcionais , Estudos Retrospectivos , Medição de Risco , Fatores de Risco , Fatores de Tempo , Resultado do Tratamento , Carga Viral , Adulto Jovem
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