Objective: To analyze the incidence of hemorrhagic cystitis (HC) after allogeneic hematopoietic stem cell transplantation and the factors affecting HC, so as to provide clinical evidence for further treatment of HC.
Methods: The HC of 113 patients after allogeneic hematopoietic stem cell transplantation in Affiliated Hospital of Xuzhou Medical University between the years 2014-2016 was analyzed respectively. All cases of HC were divided into HC group and non-HC(control) group. The follow-up time: from preeonditionig day to 180 d after transplantation. The 10 clinical parameters were selected for univariate analysis with COX regression analysis: sex, age (＜25 years and 25 years), primary disease, conditioning regimen with anti-thymoglobulin(ATG), sex-mismatch in recipients, haploidential HSCT, cytomegalovirus (CMV) viremia, EB viremia, graft-versus-host disease (GVHD), and primary disease relapse, the factors significant at the 0.1 level in univariate analysis should be further evaluated by multivariate analysis using a COX regression analysis. The difference was significant at P＜0.05 in multivariate analysis.
Results: The HC occured in 31 of 113 patients (27.4%), with 5 cases of grade I (5.5%), 19 of grade II (16.8%), 5 of grade III (4.4%), and 2 of grade IV (1.8%). The median time of HC onset was 37 days (26-70 d) after transplantation. The median duration of HC was 14 days (5-55d). Univariate analysis showed that conditioning with anti-thymoglobulin (ATG) (RR=6.170, 95%CI: 1.875-20.306, P＜0.01), CMV viremia (RR=7.633, 95%CI：2.318-25.133) (P＜0.01), haploidentical HSCT (RR=0.307, 95%CI：0.137-0.686, P＜0.01), GVHD (RR=1.891, 95%CI：0.918-3.898, P＞0.05) were the risk factors for recovery from HC. The multivatiate analysis of above-mentioned risk factors with statistical significance showed that only CMV viremia (RR=4.770, 95%CI: 1.394-16.326, P＜0.05) was the indentified risk factor affecting the recovery from HC.
Conclusion: Monitoring CMV viremia and antivirotic treatment are effective measurs to prevent the occurrence of HC and promote the recovery from HC.
题目: 影响异基因造血干细胞移植后出血性膀胱炎恢复的多因素分析.
目的: 分析异基因造血干细胞移植后出血性膀胱炎（HC）的发生率及其影响HC恢复的因素，为HC进一步治疗提供临床依据。.
方法: 对徐州医科大学附属医院2014-2016年连续完成异基因造血干细胞移植的113例患者发生HC的情况进行了回顾性的分析。全部病例分为HC和非HC（对照）2组，以预处理实施之日为随访起点，移植后180 d作为随访终点。选择10个临床参数作为危险因素，采用COX回归分析进行单因素分析：性别、年龄（＜25岁和≥25岁）、原发疾病、预处理方案中是否含有抗胸腺免疫球蛋白（ATG）、移植供受体性别差异、HLA嵌合、巨细胞病毒（CMV）血症、EB病毒血症、移植物抗宿主病（GVHD）、原发病复发，所有单因素分析P＜0.01的危险因素进入多因素分析，P＜0.05为差异有统计学意义。.
结果: 113例移植患者中位年龄为28岁，共有31例（27.4%）发生HC；其中Ⅰ度5例（4.4%），Ⅱ度19例（16.8%），Ⅲ度5例（4.4%），Ⅳ度2例（1.8%），中位发生时间为移植术后37（26-70）d，中位持续时间为14（5-55）d。单因素分析发现，预处理方案中含ATG（RR=6.170，95%CI：1.875-20.306，P＜0.01）、CMV血症（RR=7.633，95%CI：2.318-25.133，P＜0.01）、单倍体相合造血干细胞移植（RR=0.307，95%CI：0.137-0.686，P＜0.01）、移植物抗宿主病（GVHD）（RR=1.891，95%CI：0.918-3.898，P＞0.05）为影响HC恢复的高危因素。对上述有统计意义的因素进行COX多因素分析发现，CMV血症（RR=4.770，95%CI：1.394-16.326，P＜0.01）为影响HC恢复的独立危险因素。.
结论: 监测CMV血症、积极抗病毒治疗是预防HC发生，促进HC好转的有效措施。.