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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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Submitted January 4, 2005
Accepted March 31, 2005
BK DNA viral load in plasma: evidence for an association with hemorrhagic cystitis in allogeneic hematopoietic cell transplant recipients
Veronique Erard, Hyung W Kim, Lawrence Corey, Ajit Limaye, Meei-Li Huang, David Myerson, Chris Davis, and Michael Boeckh*
Division of Clinical Research, Fred Hutchinson Cancer Research Center, Seattle, WA, USA
Division of Clinical Research, Fred Hutchinson Cancer Research Center, Seattle, WA, USA; Department of Laboratory of Medicine, University of Washington, Seattle, WA, USA; Department of Medicine, University of Washington, Seattle, WA, USA
Department of Laboratory of Medicine, University of Washington, Seattle, WA, USA; Department of Medicine, University of Washington, Seattle, WA, USA
Division of Clinical Research, Fred Hutchinson Cancer Research Center, Seattle, WA, USA; Department of Pathology, University of Washinton, Seattle, WA, USA
Division of Clinical Research, Fred Hutchinson Cancer Research Center, Seattle, WA, USA; Department of Medicine, University of Washington, Seattle, WA, USA
* Corresponding author; email: mboeckh{at}fhcrc.org.
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 PCR. BK viremia detected before or during the disease was independently associated with HC (adjusted odds ratio = 30, p < 0.0001); BK viremia was even important before clinical symptoms of HC occurred (odd ratio = 11, p < 0.0001). 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 two 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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