{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,27]],"date-time":"2026-04-27T17:55:47Z","timestamp":1777312547400,"version":"3.51.4"},"reference-count":32,"publisher":"Hamad bin Khalifa University Press (HBKU Press)","issue":"3","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2021]]},"abstract":"<jats:p>Allogeneic stem cell transplant recipients are at risk of BK virus-associated hemorrhagic cystitis. This condition causes a significant morbidity and worsens clinical outcomes. The standard cares for BK virus-associated hemorrhagic cystitis are saline irrigation and forced diuresis. Notably, several beneficial roles are proposed for antiviral and anti-inflammatory agents against BK virus-associated hemorrhagic cystitis. However, cases who are at risk of cystectomy remain refractory. Herein, we present a 13-year-old boy with severe hematuria by passing two months from his allogeneic stem cell transplantation. The laboratory work up showed high BK viremia &gt;1.1 \u00d7\u00a0 10\n8\n copies\/ml in this case's urine sample. The patient was treated with antiviral agents in combination with supportive care. Moreover, intravesical alum was administered, but no clinical benefits were achieved. Finally, intravesical alprostadil was prepared under the supervision of a pediatric clinical pharmacist. In this regard, an alprostadil solution was prepared by constitution of 250 \u03bcg alprostadil in 50 mL saline. After administrating the first dose of intravesical alprostadil, an acceptable clinical response was observed, and hematuria stopped. Of note, alprostadil induces platelet aggregation and vasoconstriction. Thus, bleeding can be controlled after the administration of intravesical alprostadil. This strategy may be associated with several side effects including bladder spasm. This study is the first report describing the special role of intravesical alprostadil in refractory cases of BK virus-associated hemorrhagic cystitis. In such refractory cases, clinicians can use intravesical alprostadil rather than invasive therapies in the treatment of BK virus-hemorrhagic cystitis.<\/jats:p>","DOI":"10.5339\/qmj.2021.51","type":"journal-article","created":{"date-parts":[[2021,11,26]],"date-time":"2021-11-26T10:30:49Z","timestamp":1637922649000},"source":"Crossref","is-referenced-by-count":0,"title":["Intravesical alprostadil as a promising agent in BK virus-associated hemorrhagic cystitis: A report of a refractory case"],"prefix":"10.5339","volume":"2021","author":[{"given":"Shahin","family":"Shamsian","sequence":"first","affiliation":[{"name":"Pediatric Congenital Hematologic Disorders Research Center, Mofid Children's Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ali","family":"Saffaei","sequence":"additional","affiliation":[{"name":"Student Research Committee, Department of Clinical Pharmacy, School of Pharmacy, Shahid Beheshti University of Medical Sciences, Tehran, Iran"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Fatemeh","family":"Malek","sequence":"additional","affiliation":[{"name":"Pediatric Congenital Hematologic Disorders Research Center, Mofid Children's Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Zahra","family":"Khafafpour","sequence":"additional","affiliation":[{"name":"Pediatric Congenital Hematologic Disorders Research Center, Mofid Children's Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Abtin","family":"Latifi","sequence":"additional","affiliation":[{"name":"Pediatric Congenital Hematologic Disorders Research Center, Mofid Children's Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mahdieh","family":"Karamat","sequence":"additional","affiliation":[{"name":"Student Research Committee, Department of Clinical Pharmacy, School of Pharmacy, Shahid Beheshti University of Medical Sciences, Tehran, Iran"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bahador","family":"Mirrahimi","sequence":"additional","affiliation":[{"name":"Department of Clinical Pharmacy, School of Pharmacy, Shahid Beheshti University of Medical Sciences, Tehran, Iran E-mail: bahador.p.d@gmail.com"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"3277","reference":[{"issue":"(5):","key":"CIT0001","series-title":"Am J Blood Res","first-page":"217\u2013230","article-title":"Treatment protocols for BK virus associated hemorrhagic cystitis after hematopoietic stem cell transplantation","volume":"10","year":"2020;"},{"issue":"(3):","key":"CIT0002","series-title":"Turk J Haematol","first-page":"186\u2013192","article-title":"Prospective analysis of hemorrhagic cystitis and BK viremia in allogeneic hematopoietic stem cell transplantation","volume":"37","year":"2020;"},{"issue":"(2):","key":"CIT0003","series-title":"Cent European J Urol","first-page":"94\u2013103","article-title":"Pathogenicity of BK virus on the urinary system","volume":"63","year":"2020;"},{"issue":"(3):","key":"CIT0004","series-title":"Bone Marrow Transplant","first-page":"347\u2013350","article-title":"Treatment of BK virus-associated hemorrhagic cystitis and simultaneous CMV reactivation with cidofovir","volume":"26","year":"2000;"},{"issue":"(12):","key":"CIT0005","series-title":"Bone Marrow Transplant","first-page":"783\u2013787","article-title":"Low-dose cidofovir treatment of BK virus-associated hemorrhagic cystitis in recipients of hematopoietic stem cell transplant","volume":"39","year":"2007;"},{"issue":"(6):","key":"CIT0006","series-title":"Zhonghua Nei Ke Za Zhi","first-page":"414\u2013418","article-title":"Surgical treatment of severe, refractory hemorrhagic cystitis following allogeneic hematopoietic stem cell transplantation: a report of 17 patients","volume":"56","year":"2017;"},{"issue":"(4):","key":"CIT0007","series-title":"Scand J Urol Nephrol","first-page":"281\u2013284","article-title":"Successful treatment of cyclophosphamide-induced haemorrhagic cystitis with intravesical prostaglandin E1 in a child with non-Hodgkin's lymphoma","volume":"45","year":"2011;"},{"issue":"(6):","key":"CIT0008","series-title":"J Urol","first-page":"1850\u20131855","article-title":"Oncologic outcome and urinary function after radical cystectomy for rhabdomyosarcoma in children: role of the orthotopic ileal neobladder based on 15-year experience at a single center","volume":"191","year":"2014;"},{"issue":"(1):","key":"CIT0009","series-title":"Eur Urol Focus","first-page":"19\u201329","article-title":"Critical review of outcomes from radical cystectomy: can complications from radical cystectomy be reduced by surgical volume and robotic surgery","volume":"2","year":"2016;"},{"issue":"(1):","key":"CIT0010","series-title":"Semin Arthritis Rheum","first-page":"37\u201349","article-title":"Prostaglandins in health and disease: an overview","volume":"36","year":"2006;"},{"issue":"(3):","key":"CIT0011","series-title":"Int J Surg","first-page":"34\u201342","article-title":"BK virus associated haemorrhagic cystitis. a systematic review of current prevention and treatment strategies","volume":"63","year":"2019;"},{"issue":"(3):","key":"CIT0012","series-title":"Expert Opin Pharmacother","first-page":"421\u2013428","article-title":"Alprostadil for the treatment of impotence","volume":"15","year":"2014;"},{"issue":"(4):","key":"CIT0013","first-page":"742\u2013750","article-title":"Efficacy of alprostadil in preventing contrast-induced nephropathy in patients undergoing percutaneous coronary intervention: A multicenter prospective randomized controlled trial","volume":"91","year":"2018;"},{"issue":"(1):","key":"CIT0014","series-title":"Clin Hemorheol Microcirc","first-page":"49\u201357","article-title":"Effects of alprostadil on blood rheology and nucleoside metabolism in patients affected with lower limb chronic ischaemia","volume":"24","year":"2001;"},{"issue":"17:","key":"CIT0015","series-title":"Adv Neurobiol","first-page":"3\u201314","article-title":"Phosphodiesterase diversity and signal processing within cAMP signaling networks","year":"2017;"},{"issue":"(10):","key":"CIT0016","series-title":"Curr Treat Options Neurol","first-page":"45\u201345","article-title":"Treatment options for urogenital dysfunction in Parkinson's disease","volume":"18","year":"2016;"},{"issue":"(5):","key":"CIT0001","series-title":"Am J Blood Res","first-page":"217\u2013230","article-title":"Treatment protocols for BK virus associated hemorrhagic cystitis after hematopoietic stem cell 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transplant","volume":"39","year":"2007;"},{"issue":"(6):","key":"CIT0006","series-title":"Zhonghua Nei Ke Za Zhi","first-page":"414\u2013418","article-title":"Surgical treatment of severe, refractory hemorrhagic cystitis following allogeneic hematopoietic stem cell transplantation: a report of 17 patients","volume":"56","year":"2017;"},{"issue":"(4):","key":"CIT0007","series-title":"Scand J Urol Nephrol","first-page":"281\u2013284","article-title":"Successful treatment of cyclophosphamide-induced haemorrhagic cystitis with intravesical prostaglandin E1 in a child with non-Hodgkin's lymphoma","volume":"45","year":"2011;"},{"issue":"(6):","key":"CIT0008","series-title":"J Urol","first-page":"1850\u20131855","article-title":"Oncologic outcome and urinary function after radical cystectomy for rhabdomyosarcoma in children: role of the orthotopic ileal neobladder based on 15-year experience at a single center","volume":"191","year":"2014;"},{"issue":"(1):","key":"CIT0009","series-title":"Eur Urol Focus","first-page":"19\u201329","article-title":"Critical review of outcomes from radical cystectomy: can complications from radical cystectomy be reduced by surgical volume and robotic surgery","volume":"2","year":"2016;"},{"issue":"(1):","key":"CIT0010","series-title":"Semin Arthritis Rheum","first-page":"37\u201349","article-title":"Prostaglandins in health and disease: an overview","volume":"36","year":"2006;"},{"issue":"(3):","key":"CIT0011","series-title":"Int J Surg","first-page":"34\u201342","article-title":"BK virus associated haemorrhagic cystitis. a systematic review of current prevention and treatment strategies","volume":"63","year":"2019;"},{"issue":"(3):","key":"CIT0012","series-title":"Expert Opin Pharmacother","first-page":"421\u2013428","article-title":"Alprostadil for the treatment of impotence","volume":"15","year":"2014;"},{"issue":"(4):","key":"CIT0013","first-page":"742\u2013750","article-title":"Efficacy of alprostadil in preventing contrast-induced 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