Hemorrhagic Cystitis in Allogeneic Stem Cell Transplantation: A Role for Age and Prostatic Hyperplasia

This study analyzed 237 patients who underwent allogeneic hematopoietic stem-cell transplantation to identify risk factors for hemorrhagic cystitis (HC). HC occurred in 17% of patients, with a higher incidence in males (21% vs 11%). Key risk factors included age over 55, male gender, mismatched-HLA, reduced intensity conditioning, and cyclophosphamide-based GVHD prophylaxis. Prostatic hyperplasia was an additional risk factor in males, with 32% of those with larger prostates developing HC. The study concluded that age is the major risk factor for HC, and in males, prostatic hyperplasia also plays a significant role. The findings suggested that more intensive prophylactic strategies could be beneficial for high-risk patients to reduce prolonged hospitalization and non-relapse mortality associated with HC.