{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,13]],"date-time":"2026-08-13T23:27:52Z","timestamp":1786663672638,"version":"build-2736575974"},"reference-count":23,"publisher":"Georg Thieme Verlag KG","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Klin Padiatr"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>BK polyomavirus is one of the most common viral causes of late-stage\n                        hemorrhagic cystitis in pediatric allogeneic hematopoietic stem cell\n                        transplantation. However, there are no established diagnostic and\n                        therapeutic standards. This study examined the clinical features, risk\n                        factors, and treatment approaches of BK polyomavirus-associated hemorrhagic\n                        cystitis in pediatric hematopoietic stem cell transplantation patients.<\/jats:p>\n                  <jats:p>Pediatric patients who underwent hematopoietic stem cell transplantation at\n                        our center between January 2018 and October 2023 and developed BK\n                        polyomavirus-associated hemorrhagic cystitis were retrospectively\n                        included.<\/jats:p>\n                  <jats:p>A total of 34 pediatric hematopoietic stem cell transplantation recipients\n                        with BK polyomavirus associated hemorrhagic cystitis were analyzed. Viruria\n                        was seen in all patients and viremia in 55.8% of patients. Hematuria was\n                        graded 1\u20134 in all patients; among which, 52.9% (18) had mild hemorrhagic\n                        cystitis (grades 1 and 2) and 47.1% (16) had severe hemorrhagic cystitis\n                        (grades 3 and 4). Bladder hematomas occurred far more frequently in severe\n                        hemorrhagic cystitis (p&lt;0.01). Spontaneous recovery was more\n                        common in the mild hemorrhagic cystitis group (68.8%) than in the severe\n                        group (31.3%), whereas mortality occurred more frequently in severe\n                        hemorrhagic cystitis, although not BK polyomavirus-mediated (p=0.01).\n                        Treatment included immunosuppression reduction, intravesical and intravenous\n                        cidofovir, hyperbaric oxygen, and supportive care.<\/jats:p>\n                  <jats:p>BK polyomavirus associated hemorrhagic cystitis is a common and challenging\n                        complication in pediatric hematopoietic stem cell transplantation\n                        recipients. Clarification of risk factors and optimization of supportive and\n                        antiviral treatments can potentially reduce the morbidity of this\n                        process.<\/jats:p>","DOI":"10.1055\/a-2763-6066","type":"journal-article","created":{"date-parts":[[2026,8,13]],"date-time":"2026-08-13T22:53:23Z","timestamp":1786661603000},"source":"Crossref","is-referenced-by-count":0,"title":["BK Virus Associated Hemorrhagic Cystitis in Pediatric Hematopoietic\n                    Stem Cell Transplantation Recipients: A Retrospective Analysis"],"prefix":"10.1055","author":[{"given":"Hatice Burcu","family":"\u00c7a\u011flar K\u0131z\u0131l","sequence":"additional","affiliation":[{"name":"Akdeniz University Faculty of Medicine, Antalya, Turkey","place":["Antalya"],"department":["Pediatric Infectious Disease"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0716-7607","authenticated-orcid":false,"given":"Tu\u011f\u00e7e","family":"Tural Kara","sequence":"additional","affiliation":[{"name":"Akdeniz University Faculty of Medicine, Antalya, Turkey","place":["Antalya"],"department":["Pediatric Infectious Disease"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ay\u015fe K\u00fcbra","family":"A\u00e7\u0131k","sequence":"additional","affiliation":[{"name":"Akdeniz University Faculty of Medicine, Antalya, Turkey","place":["Antalya"],"department":["Pediatric Infectious Disease"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Onur","family":"Tekeli","sequence":"additional","affiliation":[{"name":"Akdeniz University Faculty of Medicine, Antalya, Turkey","place":["Antalya"],"department":["Pediatric Infectious Disease"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hafize Selma","family":"\u00c7etin","sequence":"additional","affiliation":[{"name":"Akdeniz University Faculty of Medicine, Antalya, Turkey","place":["Antalya"],"department":["Pediatric Infectious Disease"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Funda","family":"Tayfun K\u00fcpesiz","sequence":"additional","affiliation":[{"name":"Akdeniz University Faculty of Medicine, Antalya, Turkey","place":["Antalya"],"department":["Pediatric Hematology and Oncology"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Osman Alphan","family":"K\u00fcpesiz","sequence":"additional","affiliation":[{"name":"Akdeniz University Faculty of Medicine, Antalya, Turkey","place":["Antalya"],"department":["Pediatric Hematology and Oncology"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elif","family":"G\u00fcler","sequence":"additional","affiliation":[{"name":"Akdeniz University Faculty of Medicine, Antalya, Turkey","place":["Antalya"],"department":["Pediatric Hematology and Oncology"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"194","published-online":{"date-parts":[[2026,8,13]]},"reference":[{"key":"ref1","doi-asserted-by":"crossref","first-page":"611","DOI":"10.1016\/S1473-3099(03)00770-9","article-title":"Polyomavirus BK","volume":"3","author":"H H Hirsch","year":"2003","journal-title":"Lancet Infect Dis"},{"key":"ref2","doi-asserted-by":"crossref","first-page":"191","DOI":"10.1086\/321813","article-title":"BK virus: A clinical review","volume":"33","author":"M D Reploeg","year":"2001","journal-title":"Clin Infect Dis"},{"key":"ref3","doi-asserted-by":"crossref","first-page":"354","DOI":"10.1086\/431488","article-title":"BK virus: Opportunity makes a pathogen","volume":"41","author":"H H Hirsch","year":"2005","journal-title":"Clin Infect Dis"},{"key":"ref4","doi-asserted-by":"crossref","first-page":"503","DOI":"10.1128\/CMR.00074-16","article-title":"BK polyomavirus: Clinical aspects, immune regulation, and emerging\n                    therapies","volume":"30","author":"G R Ambalathingal","year":"2017","journal-title":"Clin Microbiol Rev"},{"key":"ref5","doi-asserted-by":"crossref","first-page":"564","DOI":"10.1016\/j.bbmt.2014.01.014","article-title":"BK virus disease after allogeneic stem cell transplantation: A cohort\n                    analysis","volume":"20","author":"N M Rorije","year":"2014","journal-title":"Biol Blood Marrow Transplant"},{"key":"ref6","first-page":"141","article-title":"BK virus infections and hemorrhagic cystitis in allogeneic hematopoietic stem\n                    cell transplant recipients","volume":"46","author":"H S\u00f6kmen","year":"2023","journal-title":"New Microbiol"},{"key":"ref7","doi-asserted-by":"crossref","first-page":"13460","DOI":"10.1111\/petr.13460","article-title":"BK viremia and nephropathy in pediatric renal transplant recipients","volume":"23","author":"Y Hamasaki","year":"2019","journal-title":"Pediatr 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ECIL guidelines for the prevention, diagnosis and treatment of BK\n                    polyomavirus-associated haemorrhagic cystitis in haematopoietic stem cell\n                    transplant recipients","volume":"73","author":"S Cesaro","year":"2018","journal-title":"J Antimicrob Chemother"},{"key":"ref10","doi-asserted-by":"crossref","first-page":"128","DOI":"10.54847\/cp.2023.03.13","article-title":"Hemorrhagic cystitis following allogeneic hematopoietic stem cell\n                    transplantation: Experience in a pediatric oncological institution","volume":"36","author":"S de la Puente","year":"2023","journal-title":"Cir Pediatr"},{"key":"ref11","doi-asserted-by":"crossref","first-page":"1283","DOI":"10.1007\/s00277-021-04454-7","article-title":"Prospective analysis of BKV hemorrhagic cystitis in children and adolescents\n                    undergoing hematopoietic cell transplantation","volume":"100","author":"M Salamonowicz-Bodzioch","year":"2021","journal-title":"Ann Hematol"},{"key":"ref12","doi-asserted-by":"crossref","first-page":"797","DOI":"10.1016\/j.bbmt.2005.06.007","article-title":"Incidence, clinical outcome, and management of virus-induced hemorrhagic\n                    cystitis in children and adolescents after allogeneic hematopoietic cell\n                    transplantation","volume":"11","author":"E Gorczynska","year":"2005","journal-title":"Biol Blood Marrow Transplant"},{"key":"ref13","first-page":"172","article-title":"BK virus infection in transplant recipients: Clinical manifestations, treatment\n                    options and the immune response","volume":"70","author":"M C van Aalderen","year":"2012","journal-title":"Neth J Med"},{"key":"ref14","doi-asserted-by":"crossref","first-page":"34","DOI":"10.15171\/jnp.2016.06","article-title":"Evaluation of leflunomide for the treatment of BK viremia and biopsy proven BK\n                    nephropathy; a single center experience","volume":"5","author":"N Nesselhauf","year":"2016","journal-title":"J Nephropathol"},{"key":"ref15","doi-asserted-by":"crossref","first-page":"363","DOI":"10.1038\/sj.bmt.1705909","article-title":"A prospective study of BK virus-associated haemorrhagic cystitis in paediatric\n                    patients undergoing allogeneic haematopoietic stem cell transplantation","volume":"41","author":"S Cesaro","year":"2008","journal-title":"Bone Marrow Transplant"},{"key":"ref16","first-page":"875","article-title":"Risk assessment for BK virus-associated hemorrhagic cystitis after pediatric\n                    hematopoietic stem cell transplant: A single-center retrospective\n                    cross-sectional study","volume":"22","author":"B S Karagun","year":"2024","journal-title":"Exp Clin Transplant"},{"key":"ref17","doi-asserted-by":"crossref","first-page":"190","DOI":"10.1097\/MPH.0b013e3181fce388","article-title":"BK-virus-associated hemorrhagic cystitis in children after hematopoietic stem\n                    cell transplantation","volume":"33","author":"O Megged","year":"2011","journal-title":"J Pediatr Hematol Oncol"},{"key":"ref18","doi-asserted-by":"crossref","first-page":"717","DOI":"10.1111\/j.1365-2141.2008.07254.x","article-title":"Prevention and management of BK-virus associated haemorrhagic cystitis in\n                    children following haematopoietic stem cell transplantation\u2014a systematic review\n                    and evidence-based guidance for clinical management","volume":"142","author":"C Harkensee","year":"2008","journal-title":"Br J Haematol"},{"key":"ref19","doi-asserted-by":"crossref","first-page":"1528","DOI":"10.1038\/bmt.2014.181","article-title":"The risk of polyomavirus BK-associated hemorrhagic cystitis after allogeneic\n                    hematopoietic SCT is associated with myeloablative conditioning, CMV viremia and\n                    severe acute GVHD","volume":"49","author":"J Uhm","year":"2014","journal-title":"Bone Marrow Transplant"},{"key":"ref20","doi-asserted-by":"crossref","first-page":"783","DOI":"10.1038\/sj.bmt.1705678","article-title":"Low-dose cidofovir treatment of BK virus-associated hemorrhagic cystitis in\n                    recipients of hematopoietic stem cell transplant","volume":"39","author":"M R Savona","year":"2007","journal-title":"Bone Marrow Transplant"},{"key":"ref21","doi-asserted-by":"crossref","first-page":"13","DOI":"10.1177\/1043454216631952","article-title":"BK virus-associated hemorrhagic cystitis after allogeneic hematopoietic stem\n                    cell transplantation in the pediatric population","volume":"34","author":"P P\u00e9rez-Huertas","year":"2017","journal-title":"J Pediatr Oncol Nurs"},{"key":"ref22","first-page":"186","article-title":"Prospective analysis of hemorrhagic cystitis and BK viremia in allogeneic\n                    hematopoietic stem cell transplantation","volume":"37","author":"E Atilla","year":"2020","journal-title":"Turk J Haematol"},{"key":"ref23","doi-asserted-by":"crossref","first-page":"52","DOI":"10.1159\/000345852","article-title":"Efficacy and safety of leflunomide for the treatment of BK virus-associated\n                    hemorrhagic cystitis in allogeneic hematopoietic stem cell transplantation\n                    recipients","volume":"130","author":"X C Hen","year":"2013","journal-title":"Acta Haematol"}],"container-title":["Klinische P\u00e4diatrie"],"original-title":[],"language":"de","link":[{"URL":"http:\/\/www.thieme-connect.de\/products\/ejournals\/pdf\/10.1055\/a-2763-6066.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,13]],"date-time":"2026-08-13T22:53:26Z","timestamp":1786661606000},"score":1,"resource":{"primary":{"URL":"http:\/\/www.thieme-connect.de\/DOI\/DOI?10.1055\/a-2763-6066"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,8,13]]},"references-count":23,"URL":"https:\/\/doi.org\/10.1055\/a-2763-6066","archive":["Portico","CLOCKSS"],"relation":{},"ISSN":["0300-8630","1439-3824"],"issn-type":[{"value":"0300-8630","type":"print"},{"value":"1439-3824","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,8,13]]}}}