A novel view on the pathogenesis of complications after intravesical BCG for bladder cancer.
Int J Infect Dis
; 72: 63-68, 2018 Jul.
Article
in En
| MEDLINE
| ID: mdl-29778583
ABSTRACT
Intravesical bacillus Calmette-Guérin (BCG) is widely used for high-risk, non-muscle-invasive bladder cancer. This report describes four cases that illustrate the spectrum of BCG-induced complications, varying from granulomatous prostatitis to sepsis. There is considerable debate regarding whether inflammation or infection is the predominant mechanism in the pathogenesis of BCG disease. In two patients with a systemic illness, the symptoms first resolved after adding prednisone, indicating a principal role for inflammation in systemic disease. In vitro testing of T-cell responses and a mycobacterial growth inhibition assay were performed for these patients with systemic disease. The patient with mild symptoms showed more effective in vitro growth reduction of BCG, while the patient with sepsis and organ involvement had high T-cell responses but ineffective killing. While these findings are preliminary, it is believed that immunological assays, as described in this report, may provide a better insight into the pathogenesis of BCG disease in individual patients, justifying further research.
Key words
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Main subject:
Urinary Bladder Neoplasms
/
BCG Vaccine
/
Adjuvants, Immunologic
/
Neoplasm Recurrence, Local
/
Antineoplastic Agents
Type of study:
Etiology_studies
Limits:
Aged
/
Humans
/
Male
Language:
En
Journal:
Int J Infect Dis
Journal subject:
DOENCAS TRANSMISSIVEIS
Year:
2018
Document type:
Article
Affiliation country:
Netherlands