Haemorrhagic cystitis, preventive and treatment interventions in patients undergoing haematopoietic stem cell transplantation: A scoping review

Abstract

Purpose: to map (a) methodological features, (b) Haemorrhagic Cystitis (HC) preventive and treatment interventions scrutinized to date, (c) outcomes measured, and (d) trends in effectiveness as documented among Haematopoietic Stem Cell Transplanted (HSCT) adults.

Methods: A scoping review was performed in 2018. Medline, CINAHL, and Cochrane Systematic Reviews databases were researched using "haemorrhagic cystitis", "prevention", "treatment", "prevent*" and "treat*" as search terms. Handsearching was also performed. Clinical trials, randomized controlled trials, comparative and observational studies, reviews, systematic reviews and meta-analyses published in English and concerning adults were all included.

Results: Fifteen primary studies, mainly monocentric, retrospective and with a sample size <200, were identified. Seven focused on preventive (mainly continuous bladder irrigation and mesna) and eight on treatment interventions (mainly intravenous and intravesical cidofovir). The onset of micro and macrohaematuria and the clinical resolution of HC were the main measured outcomes. Positive effectiveness trends were apparent for mesna and cidofovir.

Conclusions: In HC prevention and treatment, published primary studies are sparse and further research is required with larger, multicenter, and longitudinal designs conducted at international levels, with standardized methods, interventions, outcome measures, and reported data.

Keywords: Adult patients; Haematopoietic stem cell transplantation; Haemorrhagic cystitis; Prevention; Scoping review; Treatment.