Hemorrhagic cystitis

Hemorrhagic cystitis (HC) is a common and severe complication following a hematopoietic stem cell transplantation (HSCT) in pediatric patients. To address the existing data gap related to HC, Dr Pauline Mazilier conducted a retrospective study to analyze the characteristics and treatments received by pediatric patients who developed HC following a HSCT.

The study included 163 children (0-18 years) who underwent a HSCT transplantation. In total, 24 of these patients (14.7%) developed HC, confirming the high incidence and significant morbidity associated with HC in pediatric HSCT patients. A comparison between patients with and without HC did not reveal a significant difference in age, diagnosis, donor type, stem cell source or the conditioning regimen that was used. In contrast, acute GVHD was identified as a significant risk factor for the development of HC (p = 0.01).

All patients with HC received supportive care, including platelet transfusions, pain management, and forced hydration. Severe cases required bladder irrigation, intravesical therapy, hyperbaric oxygen therapy and/or arterial embolization. Mortality rates did not significantly differ between patients with or without HC. This illustrates the fact that HC increases morbidity but rarely leads to death.