scholarly journals Granulomatous hepatitis complicating intravesical bacille calmette-guérin (BCG) therapy for high-risk superficial bladder cancer

2017 ◽  
Vol 38 (4) ◽  
Author(s):  
Arun Iyer
Keyword(s):  
Bladder Cancer ◽  
High Risk ◽  
Superficial Bladder Cancer ◽  
Granulomatous Hepatitis ◽  
Bacille Calmette Guerin ◽  
Bcg Therapy

scholarly journals Management of hepatic granulomatous tuberculosis complicating intravesical BCG for superficial bladder cancer

2012 ◽  
Vol 1 (3) ◽  
Author(s):  
Vincent Fradet ◽  
Christiane Gaudreau ◽  
Paul Perrotte ◽  
Jean Côté ◽  
Jean-Marie Paquin
Keyword(s):  
Bladder Cancer ◽  
High Risk ◽  
Mycobacterium Bovis ◽  
Superficial Bladder Cancer ◽  
Granulomatous Hepatitis ◽  
Bacille Calmette Guerin ◽  
Systemic Complications ◽  
Bcg Therapy ◽  
Intravesical Bcg ◽  
Management Alternatives

Intravesical bacille Calmette-Guérin (BCG) therapy is the most effective treatmentfor high-risk superficial bladder cancer. Severe systemic complications are rare, but may occur in approximately 1% of cases. We report a severe complicationof intravesical BCG: a disseminated Mycobacterium bovis infectionwith biopsy-proven granulomatous hepatitis in a patient with bladder cancer. We also elaborate on the different management alternatives.

scholarly journals The Recovery of an intravesical BCG-induced arthritis after RITUXIMAB treatment

2021 ◽  
Author(s):  
Nejla El amri ◽  
Héla Zeglaoui ◽  
Salma Hmila ◽  
dhouha khalifa ◽  
Sadok Lataoui ◽  
...  
Keyword(s):  
Bladder Cancer ◽  
High Risk ◽  
Rare Case ◽  
Superficial Bladder Cancer ◽  
Standard Of Care ◽  
Severe Form ◽  
Bcg Therapy ◽  
Intravesical Bcg ◽  
Risk Of Relapse

BCG intra-vesical instillation is the standard of care for superficial bladder cancer at high risk of relapse and progression. Yet, this treatment can cause dysimmune complications. Osteoarticular manifestations related to BCG therapy are rare and frequently mild. We report a rare case of a severe form successfully treated with Rituximab.

scholarly journals Mycobacterial Brain Tuberculomas due to Bacille Calmette-Guérin Intravesical Chemotherapy for Bladder Cancer: A Case Report and Literature Review

2011 ◽  
Vol 22 (3) ◽  
pp. 104-106 ◽  
Author(s):  
Vitaly Golub ◽  
Prashant Malhotra ◽  
Shital Patel
Keyword(s):  
Central Nervous System ◽  
Bladder Cancer ◽  
Nervous System ◽  
Superficial Bladder Cancer ◽  
Present Report ◽  
Bacille Calmette Guerin ◽  
Bcg Immunotherapy ◽  
Bcg Therapy ◽  
Intravesical Bcg ◽  
Intravesical Bcg Therapy

Bacille Calmette-Guérin (BCG) immunotherapy is widely used for the treatment of superficial bladder cancer. The authors believe that the present report is one of the first to document cerebral BCG tuberculoma in a 73-year-old immunocompetent man, three years after intra-vesical BCG immunotherapy. His workup revealed no identifiable extracranial source. He responded well to treatment with rifampin, ethambutol and moxifloxacin.Patients undergoing intravesical BCG therapy should be closely monitored for the development of this complication. Prolonged antitubercular therapy, possibly including moxifloxacin, appears to be beneficial in the treatment of central nervous system tuberculous infections.

Second-Line Intravesical Gemcitabine in High Risk Superficial Bladder Cancer: Our Experience

2009 ◽  
Vol 76 (3) ◽  
pp. 178-184
Author(s):  
A. Aloisi ◽  
L. Ruggera ◽  
P. Beltrami ◽  
M.A. Cerruto ◽  
F. Zattoni
Keyword(s):  
Bladder Cancer ◽  
High Risk ◽  
Superficial Bladder Cancer ◽  
Transitional Cell ◽  
Tumor Stage ◽  
Intravesical Instillation ◽  
High Grade ◽  
Second Line ◽  
Bcg Therapy

Purpose Intravesical instillation of Gemcitabine may represent a useful second-line chemotherapy in case of non-muscle-invasive bladder cancer. Herein, we reported our experience with intravesical Gemcitabine in a group of patients affected by high-grade transitional cell carcinoma (TCC) of the bladder. Materials and Methods We retrospectively analyzed a total of 17 patients (15 males and 2 females), affected by high-risk superficial bladder cancer, who were refractory, intolerant or not eligible to intravesical BCG immunotherapy. Each patient received 2000 mg of Gemcitabine diluted in 100 mL of 0.9% saline solution, administered twice a week for 6 weeks. At start, TCC stage and grade were: CIS in 10 patients, TaG3 in 5 and T1G3 in the remaining 2 cases. Those with no macroscopic lesion and negative cytology and histology were considered as complete responders; those with only positive cytology as partial responders, and those with positive biopsy or evidence of macroscopic lesions as non-responders. Results Patients’ mean age was 71.5 yrs (± 7.3 yrs standard deviation). Overall, median follow-up was 12 months [interquartile range (IQR) 9–15 months]. A complete remission was achieved in 10 cases (58.8%), a partial response in 2 (11.8%), while 5 patients (29.4%) were considered as non-responders. Tumor stage and/or grade progression was observed in 26.7% of the cases. Overall, the 6-month recurrence-free survival was 33.3%. Drug toxicity was relatively low: 2 patients developed a grade II dysuria (NCI-CTC criteria); fever >38° was observed in 1 case. Conclusions Although our experience and follow-up are still rather limited to formulate any conclusive assessment, our study seems to confirm that Gemcitabine could be used as a safe and efficient intravesical chemotherapy agent even in high grade TCCs, representing a promising second-line option in those cases who failed, were intolerant or not eligible to BCG therapy. (Urologia 2009; 76: 178–84)

Bacillus Calmette-Guérin therapy alters the progression of superficial bladder cancer.

1988 ◽  
Vol 6 (9) ◽  
pp. 1450-1455 ◽  
Author(s):  
H W Herr ◽  
V P Laudone ◽  
R A Badalament ◽  
H F Oettgen ◽  
P C Sogani ◽  
...  
Keyword(s):  
Bladder Cancer ◽  
High Risk ◽  
Disease Progression ◽  
Superficial Bladder Cancer ◽  
Bladder Preservation ◽  
High Risk Patients ◽  
Bcg Therapy ◽  
Risk Patients ◽  
Muscle Invasive

The effectiveness of BCG in preventing disease progression in patients with superficial bladder cancer is evaluated. Long-term follow-up of high-risk patients treated in a previously reported randomized control trial of intravesical plus percutaneous BCG shows that progression occurred in 41/43 (95%) of control and 23/43 (53%) of BCG-treated patients. Muscle invasive and/or metastatic disease occurred with equal frequency in the two groups, but was significantly delayed by BCG treatment (P = .012). Cystectomies were required in 18/43 (42%) control and 11/43 (26%) BCG-treated patients. Median time to cystectomy was 8 months for control v 24 months for BCG-treated patients. Based on initial treatment, survival was improved by BCG therapy (P = .032) (median follow-up 6 years). These results suggest that in high-risk patients intravesical BCG can delay disease progression, prolong the period of bladder preservation, and increase overall survival.

Safety and efficacy of intravesical bacillus Calmette-Guérin instillations in steroid-treated and immunocompromised patients

2006 ◽  
Vol 24 (18_suppl) ◽  
pp. 14507-14507
Author(s):  
O. Yossepowitch ◽  
S. E. Eggener ◽  
B. H. Bochner ◽  
S. M. Donat ◽  
H. W. Herr ◽  
...  
Keyword(s):  
Bladder Cancer ◽  
High Risk ◽  
Response Rate ◽  
Superficial Bladder Cancer ◽  
Lymphocytic Leukemia ◽  
Immunocompromised Patients ◽  
Safety And Efficacy ◽  
Inhaled Steroids ◽  
Bcg Therapy ◽  
Oral Steroids

14507 Background: We assess the safety and efficacy of intravesical bacillus Calmette-Guérin (BCG) for high-risk superficial bladder cancer in steroid-treated and immunocompromised patients. Methods: We retrospectively reviewed charts of 697 patients treated with BCG instillations from 1991 to 2004. In 24 patients (3.5%), either an underlying comorbidity directly affecting the immune system was diagnosed before BCG administration, or steroids were administered at least 6 weeks before and at the time of BCG instillations. The immunosuppressive effect of the steroids was assessed by percentage of lymphocytes. End-points were BCG response at 6 months (defined as normal cystoscopy, cytology, and biopsy when available) and treatment-related toxicity. Results: Four patients (17%) had an active lymphoma or chronic lymphocytic leukemia during administration of BCG, and 21 (88%) had a concurrent condition for which oral steroids (11 patients), inhaled steroids (14 patients), or both (4 patients) were administered. Patients treated with oral steroids had a lower percentage of lymphocytes (12.3%) compared to patients treated with inhaled steroids (17.5%) or 15 age-matched patients with high-risk superficial bladder cancer and no steroid treatment (18.6%). The overall BCG response rate at 6 months was 58%. Of the 24 patients, 10 had disease recurrence and 3 had disease progression at a median follow-up of 63.5 months (IQR 19.5, 89). One patient treated with oral steroids developed a self-limited febrile disease and worsening of myalgia 48 hours after his third BCG cycle. No other systemic adverse event following BCG therapy was recorded, and all patients completed their scheduled treatments. Conclusions: Intravesical BCG is a viable therapeutic option for patients with high-risk superficial bladder cancer and concomitant lymphoma or chronic lymphocytic leukemia, treatment with low-dose oral steroids, or treatment with inhaled steroids. The BCG response rate at 6 months and the side effects profile associated with BCG therapy in these patients are comparable to patients with no evidence of immunosuppression. Further studies are warranted to assess the safety and efficacy of BCG instillations in critically immunocompromised patients. No significant financial relationships to disclose.

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