Hematopoetik Kök Hücre Transplantasyonu olan Pediatrik Hastalarda BK Virüs Enfeksiyonları

Year 2020, , 180 - 184, 30.12.2020

Nazli Nida Kaya , İbrahim Bayram , Gökhan Öztürk Gulay Sezgin , Serhan Küpeli , Fügen Yarkın

https://doi.org/10.18678/dtfd.781232

Abstract

Amaç: BK virus (BKV) ile ilişkili hemorajik sistit (HS), hematopoetik kök hücre transplantasyonu (HKHT) yapılan hastalarda yaygın görülen bir komplikasyondur. Bu çalışmanın amacı, HKHT yapılan çocuk hastalarda BKV enfeksiyonu insidansının araştırılmasıdır.
Gereç ve Yöntemler: Çalışmaya Ekim 2015 ile Eylül 2017 tarihleri arasında izlenen, yaşları 16 ay ile 16 yıl arasında olan toplam 51 hasta dahil edilmiştir. Hastalar BKV DNA'nın idrar ve kanda tespiti için kantitatif gerçek-zamanlı polimeraz zincir reaksiyonu (Anaolia Geneworks, Türkiye) testiyle monitörize edilmiştir.
Bulgular: Hastaların 46'sına allojenik HKHT ve 5'ine otolog HKHT yapılmıştır. Allojenik nakil yapılan 46 hastanın 26'sında (%56,5) ve otolog nakil yapılan 5 hastanın 1'inde (%20,0) olmak üzere toplam 27 (%52,9) hastanın idrar ve/veya kanında BKV DNA pozitifliği saptanmıştır. Allojenik HKHT yapılan 46 hastanın 12 (%26,1)'sinde preemptif tedavi için gereken idrarda >107 kopya/ml BKV viral yük düzeyi tespit edilmiştir. Preemptif tedavi uygulanan 12 hastanın 9'unda (%75,0) HS gelişmesi önlenirken 3'ünde (%25,0) HS gelişmiş ve tedaviyle iyileşmiştir. HS gelişmeden önceki iki hafta içinde BKV virurisi >109 kopya/ml olarak tespit edilmiş ve HS prediktif tanısı için prognostik bir gösterge olarak kabul edilmiştir. BKV viremisi 1 hastada sistit gelişmesinden önceki iki hafta içinde >104 kopya/ml olarak tespit edilmiştir.
Sonuç: Yüksek riskli hastalarda HS prediktif tanısı için BKV enfeksiyonu, özellikle HKHT hastalarında BKV virüri taraması önerilir.

Keywords

BK virus, hematopoietik kök hücre transplantasyonu, hemorajik sistit, polimeraz zincir reaksiyonu

Supporting Institution

Çukurova Üniversitesi

Project Number

53/7

BK Virus Infections in Pediatric Patients with Hematopoietic Stem Cell Transplantation

Abstract

Aim: BK virus (BKV)-associated hemorrhagic cystitis (HC) is a common complication in patients after hematopoietic stem cell transplantation (HSCT). The aim of this study was to investigate the incidence of BKV infection in pediatric patients receiving HSCT.
Material and Methods: Total of 51 patients aged between 16 months and 16 years old and followed up between October 2015 and September 2017 were included in the study. The patients were monitored by quantitative real-time polymerase chain reaction (Anatolia Geneworks, Turkey) test for the detection of BKV DNA in urine and blood.
Results: Of patients, 46 received allogeneic HSCT and 5 autologous HSCT. BKV DNA positivity was detected in urine and/or blood of total 27 (52.9%) patients in whom 26 (56.5%) of 46 patients with allogeneic transplantation, and 1 (20.0%) of 5 patients with autologous transplantation. BKV viral load in urine >107 copies/ml required for preemptive treatment was detected in 12 (26.1%) of 46 patients received allogeneic HSCT. The development of HC was prevented in 9 (75.0%) of the 12 patients given preemptive treatment, while 3 (25.0%) cases developed HC and cured by treatment. BKV viruria was detected >109 copies/ml in two weeks before the onset of HC and was accepted as a prognostic indicator for predictive diagnosis of HC. BKV viremia was found >104 copies/ml in 1 patient within two weeks before the onset of cystitis.
Conclusion: Screening for BKV infection, especially BKV viruria in HSCT patients, is recommended for the predictive diagnosis of HC in patients at high risk.

Keywords

BK virus, hematopoietic stem cell transplantation, haemorrhagic cystitis, polymerase chain reaction

Project Number

53/7

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