Intra-muscular vidarabine therapy for polyomavirus-associated hemorrhagic cystitis following allogeneic hemopoietic stem cell transplantation

Hemorrhagic cystitis (HC) is a common complication following hemopoietic st em cell transplantation (HSCT), its incidence ranging from 7 to 52% of all patients. Late occurring HC frequently results from viral infections. We de scribe a patient who developed severe polyomavirus-associated HC, which res ponded dramatically to a single dose of intra-muscular vidarabine. Previous studies show an improvement in HC with vidarabine therapy, but to date onl y the intravenous route of administration has been described and responses described take from several days to weeks. This report confirms the safety and efficacy of vidarabine administered intramuscularly when used in patien ts with an adequate platelet count, thereby making its use feasible when in travenous vidarabine is not available.