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ORIGINAL RESEARCH article
Front. Pediatr.
Sec. Pediatric Hematology and Hematological Malignancies
Volume 13 - 2025 | doi: 10.3389/fped.2025.1558099
Risk Factors for Hemorrhagic Cystitis in Children with Severe Beta-Thalassemia after Allogeneic Hematopoietic Stem Cell Transplantation
Provisionally accepted- 1 Maternal and Child Health Hospital of Guangxi Zhuang Autonomous Region, Nanning, China
- 2 First Affiliated Hospital, Guangxi Medical University, Nanning, Guangxi Zhuang Region, China
To investigate the risk factors for hemorrhagic cystitis (HC) in children with severe beta-thalassemia after allogeneic hematopoietic stem cell transplantation (allo-HSCT).The clinical data of 152 children under the age of 15 who underwent allo-HSCT between January 2011 and December 2021 were retrospectively analyzed. The incidence of HC and related variables were evaluated using univariate analysis.Variables with statistical significance (P < 0.05) were included in a multivariable logistic regression model to identify independent risk factors for HC.Among the 152 children, 42 developed HC, with an incidence rate of 27.63%. The median onset time of HC was 25 days (IQR: 10-38.75 days). Univariate analysis indicated that older transplantation age, elevated pre-transplant serum ferritin levels, cytomegalovirus (CMV) infection, and prolonged neutrophil engraftment time were associated with HC occurrence (P < 0.05). Multivariable logistic regression further confirmed that older transplantation age (OR 1.236, 95% CI: 1.031-1.531, P = 0.033), elevated pre-transplant ferritin levels (OR 1.053, 95% CI: 1.028-1.086, P < 0.01), CMV infection (OR 11.522, 95% CI: 2.912-76.345, P = 0.002), and prolonged neutrophil engraftment time (OR 1.385, 95% CI: 1.109-1.793, P < 0.01) were independent risk factors for HC.Older transplantation age (>5.95 age years old) , elevated pre-transplant serum ferritin levels, CMV infection, and delayed neutrophil engraftment are independent risk factors for HC in children with severe beta-thalassemia after allo-HSCT. Early identification and intervention for these risk factors are crucial in reducing the incidence of HC.
Keywords: hemorrhagic cystitis, HC, beta-Thalassemia, Allo-HSCT, Risk factors
Received: 09 Jan 2025; Accepted: 19 Mar 2025.
Copyright: © 2025 Dou, Luo, Zhao, Wang and Qin. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence:
Ji-Gan Wang, Maternal and Child Health Hospital of Guangxi Zhuang Autonomous Region, Nanning, China
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