Adenovirus is a key pathogen in hemorrhagic cystitis associated with bone marrow transplantation

Late-onset hemorrhagic cystitis (HC) is a well-known complication of bone m arrow transplantation (BMT) that is mainly attributed to infection with BK virus (BKV) and adenovirus (AdV). From 1986 through 1998, 282 patients unde rwent BMT, and 45 of them developed HC. Urine samples tested positive for A dV in 26 patients, of which 22 showed virus type 11. Among patients who und erwent allogeneic BMT, logistic regression analysis revealed acute graft-ve rsus-host disease (grade, greater than or equal to2) to be the most signifi cant predictive factor for HC (P < .0001). In addition, a total of 193 urin e samples regularly obtained from 26 consecutive patients who underwent all ogeneic BMT were examined for BKV, JC virus (JCV), and AdV by means of poly merase chain reaction. Of patients without HC, approximately 30% of the spe cimens tested positive for BKV (58 samples) and JCV (55 samples), whereas 5 (3%) tested positive for AdV. Of the 3 samples obtained from patients with HC, the numbers of positive results for BKV, JCV, and AdV were 3, 1, and 1 , respectively; the numbers of positive results increased to 14 of 17, 9 of 17, and 10 of 17, respectively, when we added another 14 samples obtained from 14 patients with HC (P < .0001, P = .026, and, respectively). In concl usion, there was significant correlation between AdV and HC in the patients we studied.