VIDARABINE THERAPY FOR VIRUS-ASSOCIATED CYSTITIS AFTER ALLOGENEIC BONE-MARROW TRANSPLANTATION

We describe a method of diagnosing virus-associated cystitis after all ogeneic bone marrow transplantation (BMT) and treatment with vidarabin e therapy, At 7-10 days post-BMT when cystitis was suspected, we obser ved urinary sediments by the Papanicolaou stain to detect virus inclus ion bodies. When positive, we examined urinary sediments by transmissi on electron microscope and measured the diameter of viral particles to determine the families, This process needed only 4 days, Among 16 con secutive cases, adenovirus and polyomavirus were each detected in thre e. Adenovirus caused hemorrhagic cystitis in two eases and cystitis wi thout macroscopic hematuria in one case, Polyomavirus caused cystitis without macroscopic hematuria in one case, Polyomavirus was also detec ted in two cases without any symptoms, Vidarabine (10 mg/kg/day i.v.) was administered for 5 days as one course, Soon after one course of vi darabine, most symptoms subsided and virus inclusion bodies disappeare d in all cases except for one with severe hemorrhagic cystitis. From t hese experiences, vidarabine reduces excretion of adenovirus and polyo mavirus in the urine of BMT recipients and improves clinical symptoms in some cases of cystitis associated with these viruses.