American Journal of Medical Sciences and Medicine
ISSN (Print): 2327-6681 ISSN (Online): 2327-6657 Website: Editor-in-chief: Apply for this position
Open Access
Journal Browser
American Journal of Medical Sciences and Medicine. 2014, 2(5), 85-88
DOI: 10.12691/ajmsm-2-5-1
Open AccessReview Article

BK Virus in Allogeneic and Autologous Bone Marrow Transplantation: Review Article

Ilhami BERBER1, , Mehmet Ali ERKURT1, Funda YETKIN2, Irfan KUKU1, Emin KAYA1, Emin BODAKCI3, Mustafa KOROGLU1 and Ilknur NIZAM1

1Department of Hematology, Bone Marrow Transplantation Unit, Faculty of Medicine, Inonu University, Malatya, Turkey

2Department of Infection Disease, Faculty of Medicine, Inonu University, Malatya, Turkey

3Department of Internal Medicine, Faculty of Medicine, Inonu University, Malatya, Turkey

Pub. Date: September 21, 2014

Cite this paper:
Ilhami BERBER, Mehmet Ali ERKURT, Funda YETKIN, Irfan KUKU, Emin KAYA, Emin BODAKCI, Mustafa KOROGLU and Ilknur NIZAM. BK Virus in Allogeneic and Autologous Bone Marrow Transplantation: Review Article. American Journal of Medical Sciences and Medicine. 2014; 2(5):85-88. doi: 10.12691/ajmsm-2-5-1


The BK virus is a member of the polyomavirus family. When the immune system is compromised, as in patients undergoing chemotherapy after hematopoietic stem cell and solid organ transplantation, the virus is reactivated, leading to haemorrhagic cystitis. While the BK virus is one of the most common causes of morbidity and mortality in patients after allogeneic stem cell transplantation, it rarely occurs after autologous stem cell transplantation. The early diagnosis and treatment of viral cystitis may prevent significant morbidity and mortality associated with haemorrhagic cystitis caused by the BK virus. It is not entirely clear how the BK virus affects prognosis in patients undergoing allogeneic and autologous hematopoietic stem cell transplantation.

BK Virus Allogeneic and Autologous Bone Marrow Transplantation

Creative CommonsThis work is licensed under a Creative Commons Attribution 4.0 International License. To view a copy of this license, visit


[1]  Gardner S.D., Field A.M., Coleman D.V., Hulme B. ‘New human papovavirus (BK) isolated from urine after renal transplantation. Lancet 1971’; 1(7712):1253-1257.
[2]  Gupta G, Shapiro R, Thai N., Randhawa P,S., Vats A.. ‘Low incidence of BK virus nephropathy after simultaneous kidney pancreas transplantation’. Transplantation 2006; 82(3): 382-388.
[3]  Sanchez-Pinto L.N., Laskin B.L., Jodele S.,Hummel T.R., Yin H.J., Goebel J. ‘BK virus nephropathy in a pediatric autologous stem-cell transplant recipient.’ Pediatr Blood Cancer 2011; 56(3): 495-497.
[4]  Bista B.R., Ishwad C., Wadowsky R.M., Manna P.,Randhawa P.S., Gupta G., Adhikari M., Tyagi R., Gasper G., Vats A., ‘Development of a loop-mediated isothermal amplification assay for rapid detection of BK virus. J Clin Microbiol ‘2007; 45(5): 1581-1587.
[5]  Schaub S., Hirsch H.H., Dickenmann M., Steiger J., Mihatsch M.J., Hopfer H., Mayr M.,. ‘Reducing immunosuppression preserves allograft function in presumptive and definitive polyomavirus-associated nephropathy. Am J Transplant’. 2010; 10(12): 2615-2623.
[6]  Rummans T.A., Nonopioid agents for treatment of acute and subacute pain. Mayo Clin Proc 1994; 69(5): 481-490.
[7]  Pergialiotis V., Arnos P., Mavros M.N., Pitsouni E., Athanasiou S., Falagas M.E., ‘Urinary tract analgesics for the treatment of patients with acute cystitis: where is the clinical evidence? Expert Rev Anti Infect Ther’ 2012; 10(8): 875-879.
[8]  Manikandan R., Kumar S., Dorairajan L.N., Hemorrhagic cystitis: ‘A challenge to the urologist. Indian J Urol’ 2010; 26(2): 159-166.
[9]  Hatakeyama N., Suzuki N., Kudoh T., Hori T., Mizue N., Tsutsumi H., ‘ Successful cidofovir treatment of adenovirus-associated hemorrhagic cystitis and renal dysfunction after allogenic bone marrow transplant.’ Pediatr Infect Dis J 2003; 22(10): 928-929.
[10]  Dropulic L.K., Jones R.J., ! Polyomavirus BK infection in blood and marrow transplant recipients. Bone Marrow Transplant ’2008; 41(1): 11-18.
[11]  Leung A.Y., Chan M.T., Yuen K.Y., Cheng V.C., Chan K.H., Wong C.L., Liang R., Lie A.K., Kwong Y.L., ‘ Ciprofloxacin decreased polyoma BK virus load in patients who underwent allogeneic hematopoietic stem cell transplantation.’ Clin Infect Dis 2005; 40(4): 528-537.
[12]  Hughes A.J., Schwarer A.P., Millar I.L., ‘ Hyperbaric oxygen in the treatment of refractory hemorrhagic cystitis. Bone Marrow Transplant ’1998; 22(6): 585-586.
[13]  Zhou W., Sharma M., Martinez J., Srivastava T., Diamond D.J., Knowles W., Lacey S.F., ‘Functional characterization of BK virus-specific CD4+ T cells with cytotoxic potential in seropositive adults’. Viral Immunol 2007; 20(3): 379-388.
[14]  Erard V., Storer B., Corey L., Nolkamper J.,.Huang M.L., Limaye A., Boeckh M., ‘ BK virus infection in hematopoietic stem cell transplant recipients: frequency, risk factors, and association with postengraftment hemorrhagic cystitis’. Clin Infect Dis 2004; 39(12): 1861-1865.
[15]  Giraud G., Bogdanovic G., Priftakis P., Remberger M., Svahn B.M., Barkholt L., Ringden O.,Winiarski J., Ljungman P., Dalianis T.,’ The incidence of hemorrhagic cystitis and BK-viruria in allogeneic hematopoietic stem cell recipients according to intensity of the conditioning regimen. Haematologica’. 2006; 91: 401-404.
[16]  Goudsmit J., Wertheim-van Dillen P., Van Strien A., Van der Noordaa J., ‘The role of BK virus in acute respiratory tract disease and the presence of BKV DNA in tonsils.’ J Med Virol 1982; 10(2): 91-99.
[17]  Droller M.J., Saral R., Santos G.,’ Prevention of cyclophosphamide- induced hemorrhagic cystitis.’ Urology.1982; 20(3): 256-258.
[18]  González-Fraile M.I., Cañizo C., Caballero Hernandez R., Vazguez L., Lopez C., Izarra A., Arroyo JL., de la Loma A., Otero MJ., San miguel JF., ‘Cidofovir treatment of human polyomavirus-associated acute haemorrhagic cystitis.’ Transpl Infect Dis 2001; 3(1): 44-46.
[19]  Gorczynska E., Turkiewicz D., Rybka K., Toporski J., Kalwak K., Dyla A., Szczyra Z., Chybicka A., ‘Incidence, clinical outcome, and management of virus-induced hemorrhagic cystitis in children and adolescents after allogeneic hematopoietic cell transplantation’. Biol Blood Marrow Transplant 2005;11(10): 797-804.
[20]  Held T.K., Biel S.S., Nitsche A., Kurth A., Chen S., GelderbLom H.R., Siegert W., ‘Treatment of BK virus-associated hemorrhagic cystitis and simultaneous CMV reactivation with cidofovir. Bone Marrow Transplant ‘2000; 26(3): 347-350.
[21]  Palandri F., Bonifazi F., Rossi C., Falcioni S., Arpinati M., Giannini M.B., Ansaloni F., Bandini G., Baccarani M., ‘Successful treatment of severe hemorrhagic cystitis with selective vesical artery embolization. Bone Marrow Transplant ‘2005; 35(5): 529-530.
[22]  Kwon H.J, Kang J.H, Lee J.W., Chung N.G., Kim H.K., Cho B., ‘Treatment of BK virus-associated hemorrhagic cystitis in pediatric hematopoietic stem cell transplant recipients with cidofovir: a single-center experience’. Transpl Infect Dis. 2013; 15(6): 569-574.
[23]  Cesaro S., Pillon M., Tridello G.. ‘Relationship between clinical and BK virological response in patients with late hemorrhagic cystitis treated with cidofovir: a retrospective study from the European Group for Blood and Marrow Transplantation. Bone Marrow Transplant’ 2013; 48(6): 809-813.
[24]  Savona M.R., Newton D., Frame D., Levine J.E., Mineishi S., Kaul D.R., ‘ Low-dose cidofovir treatment of BK virus-associated hemorrhagic cystitis in recipients of hematopoietic stem cell transplant. Bone Marrow Transplant ‘2007; 39(12): 783-787.
[25]  Faraci M., Cuzzubbo D., Lanino E., Di Marco E., Cirillo C., Dallorso S., Morreale G., Moroni C., Castagnola E., ‘ Low dosage cidofovir without probenecid as treatment for BK virus hamorrhagic cystitis after hemopoietic stem cell transplant’. Pediatr Infect Dis J 2009; 28(1): 55-57.
[26]  Araya C.E., Lew J.F., Fennell R.S., 3rd, Neiberger R.E., Dharnidharka V.R., Intermediate-dose cidofovir without probenecid in the treatment of BK virus allograft nephropathy’. Pediatr Transplant 2006; 10(1): 32-37.
[27]  Liacini A., Seamone M.E., Muruve D.A., Tibbles L.A., ‘Anti-BK virus mechanisms of sirolimus and leflunomide alone and in combination: toward a new therapy for BK virus infection. Transplantation ‘2010; 90(12): 1450-1457.
[28]  Chen X.C., Liu T., Li J.J., He C., Meng W.T., Huang R.,’ Efficacy and safety of leflunomide for the treatment of BK virus-associated hemorrhagic cystitis in allogeneic hematopoietic stem cell transplantation recipients’. Acta Haematol 2013; 130(1): 52-56.
[29]  Sener A., House A.A., Jevnikar A.M., Boudville N., Mcalister V.C., Muirhead N., Rehman F., Luke P.P., ‘Intravenous immunoglobulin as a treatment for BK virus associated nephropathy: one-year follow-up of renal allograft recipients’. Transplantation 2006; 81(1): 117-120.
[30]  Lekakis L.J., Macrinici V., Baraboutis I.G., Mitchell B., Howard D.S., ‘BK virus nephropathy after allogeneic stem cell transplantation: a case report and literature review’. Am J Hematol 2009; 84(4): 243-246.
[31]  Anyaegbu E.I., Almond P.S., Milligan T., Allen W.R., Gharaybeh S., Al-Akash S.I. ‘Intravenous immunoglobulin therapy in the treatment of BK viremia and nephropathy in pediatric renal transplant recipients’. Pediatr Transplant 2012; 16(1): 19-24.
[32]  Cekmen M.B., Bakirdoven S., Sayan M., Yılmaz A.,’ BK virus nephropathy developing after renal transplantation and its treatment with ciprofloxacin: a case report’. Transplant Proc 2012; 44(10): 3044-3047.
[33]  Wojciechowski D., Chanda R., Chandran S., Lee B., Webber A., Macaraig M., Tomlanovich S., Vincenti F., ‘Ciprofloxacin prophylaxis in kidney transplant recipients reduces BK virus infection at 3 months but not at 1 year’. Transplantation 2012:15; 94(11): 1117-1123.
[34]  Savva-Bordalo J., Pinho Vaz C., Sousa M.,. ‘Clinical effectiveness of hyperbaric oxygen therapy for BK-virus-associated hemorrhagic cystitis after allogeneic bone marrow transplantation’. Bone Marrow Transplant 2012; 47(8): 1095-1098.
[35]  Focosi D., Maggi F., Pistolesi D., Benedetti E., Papineschi F., Galimberti S., Ceccherini-Nelli L., Petrini M., ‘Hyperbaric oxygen therapy in BKV-associated hemorrhagic cystitis refractory to intravenous and intravesical cidofovir: case report and review of literature.’ Leuk Res 2009; 33(4): 556-560.
[36]  Blyth E., Clancy L., Simms R., Gaundar S., O’Connell P., Mickletwaite K., Gottlieb DJ., ‘BK virus-specific T cells for use in cellular therapy show specificity to multiple antigens and polyfunctional cytokine responses’. Transplantation. 2011; 92(10): 1077-1084.