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 Blood, 1 August 2005, Vol. 106, No. 3, pp. 1130-1132.
Prepublished online as a Blood First Edition Paper on April 21, 2005; DOI 10.1182/blood-2004-12-4988.

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TRANSPLANTATION
Brief report

BK DNA viral load in plasma: evidence for an association with hemorrhagic cystitis in allogeneic hematopoietic cell transplant recipients

Veronique Erard, Hyung Woo Kim, Lawrence Corey, Ajit Limaye, Meei-Li Huang, David Myerson, Chris Davis, and Michael Boeckh

From the Division of Clinical Research, Fred Hutchinson Cancer Research Center; the Department of Laboratory Medicine; and the Department of Pathology, University of Washington, Seattle, WA.

We performed a case-control study to determine the association of BK plasma viremia with hemorrhagic cystitis (HC) in hematopoietic cell transplant (HCT) recipients. Thirty cases of HC (14 of which occurred after platelet engraftment with documented BK viruria [BK-HC]) were compared with matched controls. Weekly plasma samples were tested for BK virus DNA by polymerase chain reaction (PCR). BK viremia detected before or during the disease was independently associated with HC (adjusted odds ratio = 30, P < .001); BK viremia was even important before clinical symptoms of HC occurred (odds ratio = 11, P < .001). Cases of HC and BK-HC had a significantly higher peak of BK plasma viral load than controls. BK virus was detected by in situ hybridization in bladder biopsies of 2 cases with severe HC and long-lasting BK viremia. BK virus seems to play a role in the development of HC and quantitative detection of BK DNA in plasma appears to be a marker of BK virus disease in HCT recipients.


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