Hemorrhagic cystitis after hematopoietic stem cell transplantation:much progress and many remaining issues

The manuscript by Xu et al1 addresses an importantquestion in the field of allogeneic hematopoieticprogenitor cell transplantation(HPCT):how to identifythose patients at risk for hemmoraghic cystitis.Theauthors performed a retrospective analysis of 250 patientsundergoing allogeneic HPCT following myeloablativeconditioning with busulfan and cyclophosphamide usinga standard post-transplant immunoprophylaxis withcyclosporine,short-course methotrexate and mycop-henylate.Post-transplant hematuria was relativelycommon,occurring in 29% of allogeneic transplantrecipients in this single institution series.Most of thedocumented hematuria was macroscopic(68% of cases),but 30% of patients had grade 3 or grade 4 hematuria,with the presence of blood clots in the urine.The