{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,23]],"date-time":"2026-09-23T22:45:34Z","timestamp":1790203534415,"version":"4.1.0"},"reference-count":53,"publisher":"American Society of Hematology","issue":"4","content-domain":{"domain":["ashpublications.org"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2020,2,25]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:p>BK polyomavirus (BKPyV) has been associated with hemorrhagic cystitis (HC) after allogeneic hematopoietic cell transplantation (HCT), but the natural history of HC and factors associated with the clinical course are incompletely understood. We retrospectively analyzed allogeneic HCT patients transplanted from 2007-2017 who presented after platelet engraftment or after day 28 post-HCT\u00a0with BKPyV-associated HC (BKPyV-HC), which was defined as a positive urine BKPyV PCR, \u22651 plasma BKPyV viral load result, and macroscopic hematuria (Bedi grade \u22652). Factors associated with resolution of macroscopic hematuria and resolution of all cystitis symptoms within 90 days after HC diagnosis were investigated in multivariable models. In 128 patients with BKPyV-HC, the median times from diagnosis to resolution of all symptoms, macroscopic hematuria, and urinary clots (present in 55% [71\/128]) were 24 days (15-44), 17 days (10-30), and 14 days (5-26), respectively. Ninety percent of patients had BKPyV viremia at the onset of HC with a median viral load of 1850 copies\/mL (interquartile range, 240-8550). In multivariable models, high plasma viral load (\u226510\u2009000 copies\/mL) and cytopenias at the beginning of BKPyV-HC were significantly associated with longer macroscopic hematuria and cystitis symptoms. Use of cidofovir was not associated with shorter duration of illness. In conclusion, BKPyV-HC after allogeneic HCT is characterized by prolonged and severe symptoms and requires improved management strategies. High-grade viremia and cytopenias were associated with a longer duration of BKPyV-associated HC. Accurate descriptions of disease and factors associated with prolonged recovery will inform end points of future clinical trials.<\/jats:p>","DOI":"10.1182\/bloodadvances.2019000802","type":"journal-article","created":{"date-parts":[[2020,2,19]],"date-time":"2020-02-19T14:57:06Z","timestamp":1582124226000},"page":"617-628","update-policy":"https:\/\/doi.org\/10.1182\/blood.2019cm0000","source":"Crossref","is-referenced-by-count":55,"title":["Presentation of BK polyomavirus\u2013associated hemorrhagic cystitis after allogeneic hematopoietic cell transplantation"],"prefix":"10.1182","volume":"4","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3429-4655","authenticated-orcid":false,"given":"Hannah","family":"Imlay","sequence":"first","affiliation":[{"name":"Fred Hutchinson Cancer Research Center, Seattle, WA;"},{"name":"Department of Medicine, University of Washington, Seattle, WA;"},{"name":"Department of Medicine, University of Utah, Salt Lake City, UT;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hu","family":"Xie","sequence":"first","affiliation":[{"name":"Fred Hutchinson Cancer Research Center, Seattle, WA;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7405-0906","authenticated-orcid":false,"given":"Wendy M.","family":"Leisenring","sequence":"first","affiliation":[{"name":"Fred Hutchinson Cancer Research Center, Seattle, WA;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3348-9039","authenticated-orcid":false,"given":"Elizabeth R.","family":"Duke","sequence":"first","affiliation":[{"name":"Fred Hutchinson Cancer Research Center, Seattle, WA;"},{"name":"Department of Medicine, University of Washington, Seattle, WA;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Louise E.","family":"Kimball","sequence":"first","affiliation":[{"name":"Fred Hutchinson Cancer Research Center, Seattle, WA;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Meei-Li","family":"Huang","sequence":"first","affiliation":[{"name":"Fred Hutchinson Cancer Research Center, Seattle, WA;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6333-5196","authenticated-orcid":false,"given":"Steven A.","family":"Pergam","sequence":"first","affiliation":[{"name":"Fred Hutchinson Cancer Research Center, Seattle, WA;"},{"name":"Department of Medicine, University of Washington, Seattle, WA;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joshua A.","family":"Hill","sequence":"first","affiliation":[{"name":"Fred Hutchinson Cancer Research Center, Seattle, WA;"},{"name":"Department of Medicine, University of Washington, Seattle, WA;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Keith R.","family":"Jerome","sequence":"first","affiliation":[{"name":"Fred Hutchinson Cancer Research Center, Seattle, WA;"},{"name":"Department of Laboratory Medicine, University of Washington, Seattle, WA;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Filippo","family":"Milano","sequence":"first","affiliation":[{"name":"Fred Hutchinson Cancer Research Center, Seattle, WA;"},{"name":"Department of Medicine, University of Washington, Seattle, WA;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"W. Garrett","family":"Nichols","sequence":"first","affiliation":[{"name":"Chimerix Inc., Durham, NC;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Phillip S.","family":"Pang","sequence":"first","affiliation":[{"name":"Vir Biotechnology Inc., San Francisco, CA; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hans H.","family":"Hirsch","sequence":"first","affiliation":[{"name":"Transplantation and Clinical Virology, Department of Biomedicine, University of Basel, Basel, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ajit P.","family":"Limaye","sequence":"first","affiliation":[{"name":"Department of Medicine, University of Washington, Seattle, WA;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael","family":"Boeckh","sequence":"first","affiliation":[{"name":"Fred Hutchinson Cancer Research Center, Seattle, WA;"},{"name":"Department of Medicine, University of Washington, Seattle, 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