{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,29]],"date-time":"2025-10-29T13:28:54Z","timestamp":1761744534094},"reference-count":22,"publisher":"MDPI AG","issue":"2","license":[{"start":{"date-parts":[[2017,6,26]],"date-time":"2017-06-26T00:00:00Z","timestamp":1498435200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Hematology Reports"],"abstract":"<jats:p>BK virus is a human polyoma virus. It is acquired in early childhood and remains life-long latent in the genitourinary system. BK virus replication is more common in receiving immunosuppressive therapy receiving patients and transplant patients. BK virus could cause hemorrhagic cystitis in patients with allogeneic stem cell transplantation. Hemorrhagic cystitis is a serious complication of hematopoietic stem cell transplantation. Hemorrhagic cystitis could cause morbidity and long stay in the hospital. Diagnosis is more frequently determined by the presence of BK virus DNA detected with quantitative or real-time PCR testing in serum or plasma and less often in urine. The reduction of immunosuppression is effective in the treatment of BK virus infection. There are also several agents with anti-BK virus activity. Cidofovir is an active agent against a variety of DNA viruses including poliomyoma viruses and it is a cytosine nucleotide analogue. Intravenous immunoglobulin IgG (IVIG) also includes antibodies against BK and JC (John Cunningham) viruses. Hereby, we report three cases of hemorrhagic cystitis. Hemorrhagic cystitis developed in all these three cases of allogeneic stem cell transplantation due to acute myeloid leukemia (AML). BK virus were detected as the cause of hemorrhagic cystitis in these patients. Irrigation of the bladder was performed. Then levofloxacin 1 \u00d7 750 mg intravenous and IVIG 0.5 gr\/kg were started. But the hematuria did not decreased. In the first case, treatment with leflunomide was started, but patient died due to refractory AML and severe graft-versus-host disease after 4th day of leflunamide and levofloxacin treatments. Cidofovir treatment and the reduction of immunosuppressive treatment decreased the BK virus load and resulted symptomatic improvement in the second case. Initiation of cidofovir was planned in the third case. Administration of cidofovir together with the reduction of immunosuppression in the treatment of hemorrhagic cystitis associated with BK virus in allogeneic stem cell transplant recipients could be a good option.<\/jats:p>","DOI":"10.4081\/hr.2017.7205","type":"journal-article","created":{"date-parts":[[2017,6,28]],"date-time":"2017-06-28T07:29:12Z","timestamp":1498634952000},"page":"7205","source":"Crossref","is-referenced-by-count":11,"title":["BK Virus-Associated Hemorrhagic Cystitis in Patients w\u0131th Allogeneic Hematopoietic Cell Transplantation: Report of Three Cases"],"prefix":"10.3390","volume":"9","author":[{"given":"Duygu","family":"Mert","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hikmetullah","family":"Batgi","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alparslan","family":"Merdin","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sabahat","family":"\u00c7eken","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mehmet Sinan","family":"Dal","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Emre","family":"Tekgu\u0308ndu\u0308z","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Fevzi","family":"Altunta\u015f","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mustafa","family":"Ertek","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2017,6,26]]},"reference":[{"key":"ref1","doi-asserted-by":"crossref","first-page":"354","DOI":"10.1086\/431488","article-title":"BK virus: opportunity makes a pathogen","volume":"41","author":"Hirsch","year":"2005","journal-title":"Clin Infect Dis"},{"key":"ref2","doi-asserted-by":"crossref","first-page":"182","DOI":"10.1007\/s004310050047","article-title":"Clinical course and treatment of haemorrhagic cystitis associated with BK type of human polyomavirus in nine paediatric recipients of allogeneic bone marrow transplants","volume":"159","author":"Peinemann","year":"2000","journal-title":"Eur J Pediatr"},{"key":"ref3","doi-asserted-by":"crossref","first-page":"2565","DOI":"10.1093\/ndt\/gfr675","article-title":"Trends in immune function assay (ImmuKnow, Cylex) results in the first year post-transplant and relationship to BK virus infection","volume":"27","author":"Gralla","year":"2012","journal-title":"Nephrol Dial Transplant"},{"key":"ref4","series-title":"Transplant infections","first-page":"465","article-title":"Polyoma and papilloma virus infections after hematopoietic stem cell or solid organ transplantation","author":"Hirsch","year":"2010"},{"key":"ref5","doi-asserted-by":"crossref","first-page":"1183","DOI":"10.3324\/haematol.2009.016758","article-title":"Hemorrhagic cystitis after allogeneic hematopoietic stem cell transplants is the complex result of BK virus infection, preparative regimen intensity and donor type","volume":"95","author":"Silva","year":"2010","journal-title":"Haematologica"},{"key":"ref6","doi-asserted-by":"crossref","first-page":"230","DOI":"10.1056\/NEJM198607243150405","article-title":"Association of BK viruria with hemorrhagic cystitis in recipients of bone marrow transplants","volume":"315","author":"Arthur","year":"1986","journal-title":"N Engl J Med"},{"key":"ref7","doi-asserted-by":"crossref","first-page":"984","DOI":"10.1097\/01.TP.0000157573.90090.FD","article-title":"Monitoring for polyomavirus BK and JC in urine: comparison of quantitative polymerase chain reaction with urine cytology","volume":"79","author":"Randhawa","year":"2005","journal-title":"Transplantation"},{"key":"ref8","doi-asserted-by":"crossref","first-page":"850","DOI":"10.1097\/TP.0b013e318166cba8","article-title":"Successful treatment of BK viremia using reduction in immunosuppression without antiviral 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Transplant"},{"key":"ref12","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 recipients of hematopoietic stem cell transplant","volume":"39","author":"Savona","year":"2007","journal-title":"Bone Marrow Transplant"},{"key":"ref13","doi-asserted-by":"crossref","first-page":"233","DOI":"10.1086\/599829","article-title":"Cidofovir for BK virus associated hemorrhagic cystitis: a retrospective study","volume":"49","author":"Cesaro","year":"2009","journal-title":"Clin Infect Dis"},{"key":"ref14","doi-asserted-by":"crossref","first-page":"809","DOI":"10.1038\/bmt.2012.247","article-title":"Relationship between clinical and BK virologicai response in patients with late hemorrhagic cystitis treated with cidofovir: a retrospective study from the European Group for Blood and Marrow Transplantation","volume":"48","author":"Cesaro","year":"2013","journal-title":"Bone Marrow 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fluoroquinolones for the prevention of BK viremia after renal transplantation","volume":"5","author":"Gabardi","year":"2010","journal-title":"Clin J Am Soc Nephrol"},{"key":"ref19","doi-asserted-by":"crossref","first-page":"2106","DOI":"10.1001\/jama.2014.14721","article-title":"Levofloxacin for BK virus prophylaxis following kidney transplantation: a randomized clinical trial","volume":"312","author":"Knoll","year":"2014","journal-title":"JAMA"},{"key":"ref20","doi-asserted-by":"crossref","first-page":"184","DOI":"10.1016\/j.jcv.2008.06.009","article-title":"BK virus antibody titers and intensity of infections after renal transplantation","volume":"43","author":"Bohl","year":"2008","journal-title":"J Clin Virol"},{"key":"ref21","doi-asserted-by":"crossref","first-page":"1564","DOI":"10.1128\/CVI.00206-08","article-title":"Longitudinal analysis of levels immunoglobulins against BK virus capsid proteins in kidney transplant 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