Abstract

No AccessJournal of Urology1 Mar 1992Incidence and Treatment of Complications of Bacillus Calmette-Guerin Intravesical Therapy in Superficial Bladder Cancer Donald L. Lamm, Ad P.M. Van Der Meijden, Alvaro Morales, Stanley A. Brosman, William J. Catalona, Harry W. Herr, Mark S. Soloway, Adolphe Steg, and Frans M.J. Debruyne Donald L. LammDonald L. Lamm More articles by this author , Ad P.M. Van Der MeijdenAd P.M. Van Der Meijden More articles by this author , Alvaro MoralesAlvaro Morales More articles by this author , Stanley A. BrosmanStanley A. Brosman More articles by this author , William J. CatalonaWilliam J. Catalona More articles by this author , Harry W. HerrHarry W. Herr More articles by this author , Mark S. SolowayMark S. Soloway More articles by this author , Adolphe StegAdolphe Steg More articles by this author , and Frans M.J. DebruyneFrans M.J. Debruyne More articles by this author View All Author Informationhttps://doi.org/10.1016/S0022-5347(17)37316-0AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Intravesical therapy with bacillus Calmette-Guerin (BCG) has proved to be more effective in the prophylaxis and treatment of superficial bladder tumors and carcinoma in situ than most chemotherapeutic agents. Compared to intravesical chemotherapy, instillations with BCG provoke more local and systemic reactions. In addition to the commonly induced granulomatous inflammatory changes in the bladder, which produce irritative symptoms, this therapy may cause systemic side effects varying from mild malaise and fever to, in rare instances, life-threatening or fatal sepsis. We report the incidence and varieties of toxicities in 2,602 patients treated with intravesical BCG. Side effects are classified according to local and systemic toxicity. Treatment options vary according to the severity of toxicity from delaying or withholding instillations to treatment with antituberculous drugs for up to 6 months. In general, 95% of the patients have no serious side effects. Recognition of risk factors, particularly traumatic catheterization or concurrent cystitis, that result in systemic BCG absorption, as well as the prompt and appropriate treatment of early side effects should significantly decrease the incidence of severe toxicity. © 1992 by The American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetailsCited ByRose A, El-Leithy T, Dorp F, Zakaria A, Eisenhardt A, Tschirdewahn S and Rübben H (2018) Mistletoe Plant Extract in Patients with Nonmuscle Invasive Bladder Cancer: Results of a Phase Ib/IIa Single Group Dose Escalation StudyJournal of Urology, VOL. 194, NO. 4, (939-943), Online publication date: 1-Oct-2015.Falke J, Lammers R, Arentsen H, Ravic M, Pozzi R, Cornel E, Vergunst H, de Reijke T and Witjes J (2018) Results of a Phase 1 Dose Escalation Study of Intravesical TMX-101 in Patients with Nonmuscle Invasive Bladder CancerJournal of Urology, VOL. 189, NO. 6, (2077-2082), Online publication date: 1-Jun-2013.Pan 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Volume 147Issue 3 Part 1March 1992Page: 596-600 Advertisement Copyright & Permissions© 1992 by The American Urological Association Education and Research, Inc.Keywordscarcinoma in situBCG vaccinebladder neoplasmsMetricsAuthor Information Donald L. Lamm More articles by this author Ad P.M. Van Der Meijden More articles by this author Alvaro Morales More articles by this author Stanley A. Brosman More articles by this author William J. Catalona More articles by this author Harry W. Herr More articles by this author Mark S. Soloway More articles by this author Adolphe Steg More articles by this author Frans M.J. Debruyne More articles by this author Expand All Advertisement PDF DownloadLoading ...