scholarly journals Disseminated Granulomatous Disease from Intravesical Instillation of Bacillus Calmette-Guerin

2018 ◽  
Vol 2018 ◽  
pp. 1-4 ◽  
Author(s):  
Sayed Ab. Reshad Ghafouri ◽  
Alexander Brun ◽  
Rohit Bhalla ◽  
Craig Margulies ◽  
Kevin Skole
Keyword(s):  
Bladder Cancer ◽  
Drug Toxicity ◽  
Standard Treatment ◽  
Superficial Bladder Cancer ◽  
Treatment Options ◽  
Intravesical Instillation ◽  
Granulomatous Disease ◽  
Bacillus Calmette Guerin ◽  
Intravesical Bcg ◽  
Bcg Instillation

Intravesical instillation of Bacillus Calmette-Guerin is one of the standard treatment options for superficial bladder cancer. While Bacillus Calmette-Guerin therapy is usually well tolerated with most patients experiencing only cystitis, in rare cases, it can lead to disseminated granulomatous disease. We present a case of a 72-year-old man with disseminated granulomatous disease from intravesical BCG instillation whose treatment was complicated by antimycobacterial drug toxicity.

scholarly journals Clinical Spectrum of Complications Induced by Intravesical Immunotherapy of Bacillus Calmette-Guérin for Bladder Cancer

2019 ◽  
Vol 2019 ◽  
pp. 1-11 ◽  
Author(s):  
Yuqing Liu ◽  
Jian Lu ◽  
Yi Huang ◽  
Lulin Ma
Keyword(s):  
Bladder Cancer ◽  
Adverse Reactions ◽  
Clinical Manifestations ◽  
Bacillus Calmette Guerin ◽  
Bcg Immunotherapy ◽  
Bcg Therapy ◽  
Intravesical Bcg ◽  
Proven Efficacy ◽  
Bcg Instillation ◽  
Early Establishment

Because of its proven efficacy, intravesical Bacillus Calmette-Guérin (BCG) immunotherapy is an important treatment for nonmuscle invasive bladder cancer at high risk of recurrence or progression. However, approximately 8% of patients have to stop BCG instillation as a result of its complications. Complications induced by BCG therapy can have a variety of clinical manifestations. These adverse reactions may occur in conjunction with BCG instillation or may not develop until months or years after BCG cessation. An essential step in the management complications arising from BCG is early establishment of diagnosis, particularly for distant, disseminated, and obscure infections. Therefore we reviewed the literature on the potential complications after intravesical BCG immunotherapy for bladder cancer and provide an overview on the incidence, diagnosis, and treatment modality of genitourinary and systemic BCG-induced complications.

scholarly journals Assessing the Feasibility of Replacing Standard-Dose Bacillus Calmette–Guérin Immunotherapy with Other Intravesical Instillation Therapies in Bladder Cancer Patients: A Network Meta-Analysis

2017 ◽  
Vol 41 (4) ◽  
pp. 1298-1312 ◽  
Author(s):  
Cheng Wu ◽  
Xunrong Zhou ◽  
Chunqing Miao ◽  
Jianzhong Zhang ◽  
Qingsheng Tang ◽  
...  
Keyword(s):  
Bladder Cancer ◽  
Tumor Recurrence ◽  
Standard Dose ◽  
Meta Analysis ◽  
Intravesical Instillation ◽  
Bacillus Calmette Guerin ◽  
Odds Ratios ◽  
Significant Difference ◽  
Intravesical Bcg ◽  
Equivalent Efficacy

Background: Bacillus Calmette–Guérin (BCG) immunotherapy plays a key role in patients with bladder cancer. The shortage of intravesical BCG has motivated researchers to seek alternatives with equivalent efficacy If other alternative intravesical agents have equivalent efficacy compared to BCG, then it may be feasible to replace standard BCG with alternative options. Methods: We searched all relevant evidence in multiple sources and key data was extracted from included studies. Conventional and network meta-analysis were conducted so that pooled odds ratios (ORs) for the event of tumor recurrence and progression can be computed. The relative efficacy of different intravesical instillation procedures was computed by pooled odds ratios and their 95% confidence or creditable intervals. Besides, several key model assumptions were evaluated in our analysis. Results: Three intravesical instillation procedures have the potential for preventing tumor recurrence: standard-dose BCG (BCG_SD), Epirubicin (EPI) and Mitomycin C (MMC) (ORs < 1). Patients with BCG SD also exhibited a decreased risk of tumor recurrence and progression compared to those with EPI. No significant difference in the risk of tumor recurrence or progression was detected between patients treated with BCG_ SD and those with low-dose BCG (BCG_LD). Results of SUCRA indicated that BCG_EPI, BCG_ MMC and BCG SD had higher rankings with respect to tumor recurrence and progression. Conclusions: BCG SD, EPI and MMC exhibited established efficacy for preventing tumor recurrence in postoperative BC patients. The efficacy of BCG may not be significantly reduced if standard dose was reduced to a lower level. However, there is no consensus suggesting that intravesical BCG with standard dose can be replaced by alternating or sequentially combined intravesical instillation therapies.

Complications of Bacillus Calmette-Guerin immunotherapy in superficial bladder cancer

1995 ◽  
Vol 62 (1_suppl) ◽  
pp. 91-93 ◽  
Author(s):  
E. Vestita ◽  
A. Manassero ◽  
C. Terrone ◽  
S. Rocca Rossetti
Keyword(s):  
Bladder Cancer ◽  
Standard Treatment ◽  
Superficial Bladder Cancer ◽  
Transitional Cell ◽  
Delayed Type Hypersensitivity ◽  
Bacterial Cells ◽  
Specific Therapy ◽  
Intravesical Bcg

— Intravesical immunotherapy with BCG has become a standard treatment of superficial recurrent transitional cell carcinoma and in-situ bladder carcinoma. Studies on the mechanism of action have demonstrated the role of T lymphocytes. Moreover clinical and experimental results suggest a role by cytochines and delayed type hypersensitivity. BCG, while effective in the treatment of bladder cancer, has a defined morbidity that can be ascribed to the fact that it consists of viable bacterial cells. We evaluated the complications and side effects of this therapy in 71 patients who had received intravesical BCG (Pasteur strain BCG was instilled weekly for 6 weeks, fortnightly for three months and monthly for 12 months at a dose of 75 mg). Our findings showed the following complications: cystitis (63.3%), hematuria (28.1%), fever (7%), two cases of pruritus (2.8%), one case of hepatitis with persistent fever. Granulomatous prostatitis was noted in four cases (5.6%), a higher incidence than reported in literature, but it is a localized and self-limiting process that does not require specific therapy. In conclusion, the treatment with intravesical BCG has a significant morbidity, but the rate of complications is low and most need no treatment.

Additional Extension of the Mathematical Model for BCG Immunotherapy of Bladder Cancer and Its Validation by Auxiliary Tool

2019 ◽  
Vol 20 (6) ◽  
pp. 675-689 ◽  
Author(s):  
Ekaterina Guzev ◽  
Sarel Halachmi ◽  
Svetlana Bunimovich-Mendrazitsky
Keyword(s):  
Bladder Cancer ◽  
Superficial Bladder Cancer ◽  
Treatment Protocol ◽  
Bacillus Calmette Guerin ◽  
Cancer Cell Growth ◽  
Model Improvement ◽  
Unnecessary Death ◽  
Clinical Potential ◽  
The Mathematical Model ◽  
Bcg Instillation

AbstractImmunotherapy with bacillus Calmette–Guérin (BCG) is a classic treatment for superficial bladder cancer. Although BCG instillation is a well-established protocol, some patients do not respond to this treatment. To model improvement of this protocol, Bunimovich-Mendrazitsky (B-M) et al. provided a platform for in silico testing of modified protocols of BCG instillation and combination with IL-2. The purpose of this work is to improve and further develop this BCG model describing the tumor–immune interactions occurring in the bladder in response to BCG and IL-2 therapies, based on novel clinical data.To validate this BCG model, we used the results of BCG treatment of 10 patients with bladder cancer 3-5 years ago. Individual data for each patient was entered to simulate the model. As a result, a treatment protocol was obtained which coincided with the protocol assigned by the doctor. In addition, cancer cell growth graphs were obtained from the model simulations, which coincided with the clinical conclusions of the patient’s treatment outcome. Moreover, the program provides a more optimal treatment protocol for each patient.We show that calculated protocols from the model can prevent excess side effects of immunotherapy and even of unnecessary death for some patients, informing the clinical potential of our model.

scholarly journals Beware of Drug Interactions Treating Iatrogenic Mycobacterium bovis Endocarditis from Intravesical BCG Instillation

2021 ◽  
Author(s):  
Francesca Curri ◽  
Andrea Da Porto ◽  
Viviana Casarsa ◽  
Daria Albini ◽  
Giorgio Minen ◽  
...  
Keyword(s):  
Bladder Cancer ◽  
Mitral Valve ◽  
Minimally Invasive ◽  
Bacillus Calmette Guerin ◽  
Antituberculous Therapy ◽  
Intravesical Bcg ◽  
Prosthetic Mitral Valve ◽  
Intravesical Instillations ◽  
Echocardiographic Evidence ◽  
Bcg Instillation

We report a case of mechanical mitral valve endocarditis associated with miliary disseminated bacillus Calmette-Guerin (BCG) infection following intravesical instillations for minimally invasive bladder cancer in a 65-year-old man. The diagnosis was established by echocardiographic evidence of vegetation on the prosthetic mitral valve, miliary lesions in the lungs and evidence of bloodstream infection sustained by Mycobacterium. We successfully treated the patient with the classical regimen of quadruple antituberculous therapy.

scholarly journals Transitory Spontaneous Remission of Myelodysplasia in an Elderly Man while Receiving Intravesical Bacillus Calmette-Guérin for Bladder Cancer: A Case Report and Review of the Literature

2018 ◽  
Vol 2018 ◽  
pp. 1-7
Author(s):  
Nigel P. Murray ◽  
Cynthia Fuentealba ◽  
Isidora Salazar ◽  
Aníbal Salazar ◽  
Marco Antonio Lopez ◽  
...  
Keyword(s):  
Bladder Cancer ◽  
Case Report ◽  
Superficial Bladder Cancer ◽  
Spontaneous Remission ◽  
Bacillus Calmette Guerin ◽  
Review Of The Literature ◽  
Intravesical Bcg

Myelodysplasia is a clonal disorder characterized by progressive cytopenias. Intravescial BCG is standard immunotherapy for superficial bladder cancer. We present a patient with transfusion-dependent myelodysplasia whose blood counts normalized during treatment with intravesical BCG for bladder cancer. After finishing treatment, the patient became transfusion dependent once more. We discuss possible mechanisms to explain this case report.

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