Polyomaviruses After Allogeneic Hematopoietic Stem Cell Transplantation

Polyomaviruses (PyVs) are non-enveloped double-stranded DNA viruses that can cause significant morbidity in allogeneic hematopoietic stem cell transplant (allo-HSCT) recipients, particularly BK polyomavirus (BKPyV) and JC polyomavirus (JCPyV). BKPyV is primarily associated with hemorrhagic cystitis...

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Main Authors: Maria Alejandra Mendoza, Hannah Imlay
Format: Article
Language:English
Published: MDPI AG 2025-03-01
Series:Viruses
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Online Access:https://www.mdpi.com/1999-4915/17/3/403
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author Maria Alejandra Mendoza
Hannah Imlay
author_facet Maria Alejandra Mendoza
Hannah Imlay
author_sort Maria Alejandra Mendoza
collection DOAJ
description Polyomaviruses (PyVs) are non-enveloped double-stranded DNA viruses that can cause significant morbidity in allogeneic hematopoietic stem cell transplant (allo-HSCT) recipients, particularly BK polyomavirus (BKPyV) and JC polyomavirus (JCPyV). BKPyV is primarily associated with hemorrhagic cystitis (HC), while JCPyV causes progressive multifocal leukoencephalopathy (PML). The pathogenesis of these diseases involves viral reactivation under immunosuppressive conditions, leading to replication in tissues such as the kidney, bladder, and central nervous system. BKPyV-HC presents as hematuria and urinary symptoms, graded by severity. PML, though rare after allo-HSCT, manifests as neurological deficits due to JCPyV replication in glial cells. Diagnosis relies on nucleic acid amplification testing for DNAuria or DNAemia as well as clinical criteria. Management primarily involves supportive care, as no antiviral treatments have proven consistently effective for either virus and need further research. This review highlights the virology, clinical presentations, and management challenges of PyV-associated diseases post-allo-HSCT, emphasizing the need for improved diagnostic tools and therapeutic approaches to mitigate morbidity and mortality in this vulnerable population.
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spelling doaj-art-d6b926816756405a96fdb776c19c649c2025-08-20T02:43:10ZengMDPI AGViruses1999-49152025-03-0117340310.3390/v17030403Polyomaviruses After Allogeneic Hematopoietic Stem Cell TransplantationMaria Alejandra Mendoza0Hannah Imlay1Division of Infectious Diseases, Department of Internal Medicine, University of Utah, Salt Lake City, UT 84112, USADivision of Infectious Diseases, Department of Internal Medicine, University of Utah, Salt Lake City, UT 84112, USAPolyomaviruses (PyVs) are non-enveloped double-stranded DNA viruses that can cause significant morbidity in allogeneic hematopoietic stem cell transplant (allo-HSCT) recipients, particularly BK polyomavirus (BKPyV) and JC polyomavirus (JCPyV). BKPyV is primarily associated with hemorrhagic cystitis (HC), while JCPyV causes progressive multifocal leukoencephalopathy (PML). The pathogenesis of these diseases involves viral reactivation under immunosuppressive conditions, leading to replication in tissues such as the kidney, bladder, and central nervous system. BKPyV-HC presents as hematuria and urinary symptoms, graded by severity. PML, though rare after allo-HSCT, manifests as neurological deficits due to JCPyV replication in glial cells. Diagnosis relies on nucleic acid amplification testing for DNAuria or DNAemia as well as clinical criteria. Management primarily involves supportive care, as no antiviral treatments have proven consistently effective for either virus and need further research. This review highlights the virology, clinical presentations, and management challenges of PyV-associated diseases post-allo-HSCT, emphasizing the need for improved diagnostic tools and therapeutic approaches to mitigate morbidity and mortality in this vulnerable population.https://www.mdpi.com/1999-4915/17/3/403JC virusBK viruspolyomavirushematopoietic stem cell transplantprogressive multifocal leukoencephalopathyhemorrhagic cystitis
spellingShingle Maria Alejandra Mendoza
Hannah Imlay
Polyomaviruses After Allogeneic Hematopoietic Stem Cell Transplantation
Viruses
JC virus
BK virus
polyomavirus
hematopoietic stem cell transplant
progressive multifocal leukoencephalopathy
hemorrhagic cystitis
title Polyomaviruses After Allogeneic Hematopoietic Stem Cell Transplantation
title_full Polyomaviruses After Allogeneic Hematopoietic Stem Cell Transplantation
title_fullStr Polyomaviruses After Allogeneic Hematopoietic Stem Cell Transplantation
title_full_unstemmed Polyomaviruses After Allogeneic Hematopoietic Stem Cell Transplantation
title_short Polyomaviruses After Allogeneic Hematopoietic Stem Cell Transplantation
title_sort polyomaviruses after allogeneic hematopoietic stem cell transplantation
topic JC virus
BK virus
polyomavirus
hematopoietic stem cell transplant
progressive multifocal leukoencephalopathy
hemorrhagic cystitis
url https://www.mdpi.com/1999-4915/17/3/403
work_keys_str_mv AT mariaalejandramendoza polyomavirusesafterallogeneichematopoieticstemcelltransplantation
AT hannahimlay polyomavirusesafterallogeneichematopoieticstemcelltransplantation