[CIS-PAGID] post transplant BK infection

[Cowan, Mort]

You might want to contact Michael Boeckh (mboeckh at fhcrc.org) at the Fred
Hutch in Seattle as he has had a lot of experience with BK virus
infections. We've not had much success in treating BK in the urine but I
agree, with the apparent severity in your patient, we would be using
cidofovir as well. Mort

 

Morton J. Cowan, M.D.

Professor of Pediatrics

Chief, Blood and Marrow Transplant Division

UCSF Children's Hospital, Room M659

505 Parnassus Ave

San Francisco, CA 94143-1278

 

Phone: 415-476-2188

FAX: 415-502-4867

 

**Confidentiality Notice** This email communication and any attachments
may contain confidential and privileged information for the use of the
designated recipients named above. Distribution, reproduction or any
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recipient is prohibited.

 

From: pagid-bounces at list.clinimmsoc.org
[mailto:pagid-bounces at list.clinimmsoc.org] On Behalf Of Richard
Wasserman
Sent: Thursday, June 23, 2011 10:17 AM
To: pagid at list.clinimmsoc.org
Subject: Re: [CIS-PAGID] post transplant BK infection

 

The patient is currently receiving cidofovir and has a cystotomy. She
has been transfused. I don't know about plasma BK PCR. Other than
knowing more virus is bad how does one interpret the difference between
1000, 10,000, 100,000 and 1,000,000 virons? Is there data that plasma
viral load is more prognostic than urinary load?

Richard

 

On Thu, Jun 23, 2011 at 11:41 AM, Cowan, Mort <mcowan at peds.ucsf.edu>
wrote:

Have they gotten a plasma BK PCR? If it's positive people have used
cidofovir with some success. If it's just in the bladder then usually
you just treat the hemorrhagic cystitis with hydration, looking to avoid
clot formation in the bladder, until it resolves on its own. This can
take several weeks. How severe is it? Are transfusions being required
and at what frequency? I suppose you could consider cidofovir if it's
severe enough even if not systemic infection. The issue, of course, is
the renal toxicity from cidofovir but probenecid protects the kidneys to
some extent.

 

Mort

 

Morton J. Cowan, M.D.

Professor of Pediatrics

Chief, Blood and Marrow Transplant Division

UCSF Children's Hospital, Room M659

505 Parnassus Ave

San Francisco, CA 94143-1278

 

Phone: 415-476-2188

FAX: 415-502-4867

 

**Confidentiality Notice** This email communication and any attachments
may contain confidential and privileged information for the use of the
designated recipients named above. Distribution, reproduction or any
other use of this transmission by any party other than the intended
recipient is prohibited.

 

From: pagid-bounces at list.clinimmsoc.org
[mailto:pagid-bounces at list.clinimmsoc.org] On Behalf Of Kirkpatrick,
Charles
Sent: Thursday, June 23, 2011 8:43 AM


To: 'pagid at list.clinimmsoc.org'
Subject: Re: [CIS-PAGID] post transplant BK infection

 

Richard:

 

I have a patient with CVID who was also on immunosuppression for her
renal transplant.  Her BK virus infection cleared when the transplant
team reduced her immunosuppressive treatment.  There were no adverse
effects on kidney function.

 

Chuck Kirkpatrick

 

From: pagid-bounces at list.clinimmsoc.org
[mailto:pagid-bounces at list.clinimmsoc.org] On Behalf Of Richard
Wasserman
Sent: Wednesday, June 22, 2011 3:09 PM


To: PAGID
Subject: [CIS-PAGID] post transplant BK infection

 

My heme/onc colleagues have transplanted a two year old AML in remission
who is now one month post-transplant and has reconstituted well. She
would be home at this time but for severe hemorrhagic cystitis due to BK
viral infection. Any suggestions?
Thank you,
Richard Wasserman

-- 
Richard L. Wasserman, MD, PhD
DallasAllergyImmunology
7777 Forest Lane, Suite B-332
Dallas, Texas 75230
Office (972) 566-7788 <tel:%28972%29%20566-7788> 
Fax (972) 566-8837 <tel:%28972%29%20566-8837> 
Cell (214) 697-7211 <tel:%28214%29%20697-7211> 




-- 
Richard L. Wasserman, MD, PhD
DallasAllergyImmunology
7777 Forest Lane, Suite B-332
Dallas, Texas 75230
Office (972) 566-7788
Fax (972) 566-8837
Cell (214) 697-7211

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