BCG infections after BCG instillation therapy on the rise in bladder cancer patients

Finland: In a new study published in British Journal of Urology International, it was shown that the prevalence of Bacille Calmette-Guérin (BCG) infections among bladder cancer patients managed with BCG has climbed to 2.5% on a national scale, with a significantly higher fatality rate than previously reported.

The most efficient intravesical immunotherapy for superficial bladder cancer is Bacille Calmette-Guérin (BCG). Although BCG is typically well tolerated, infectious problems may arise after instillation. While these incidents are infrequent, with a cumulative frequency of less than 5%, the physician has a difficulty because to the wide diversity of symptoms and possible severity. Pertti Nurminen and colleagues undertook this study to assess the incidence and mortality related with Bacille Calmette-Guérin infections in a Finnish sample of bladder cancer patients treated with BCG instillations.

With the help of the Finnish Cancer Registry and the Finnish National Infectious Diseases Register, researchers identified patients with BCG infections in Finland from 1996 to 2016. The number of individuals treated with BCG instillations was determined using data on nationwide ingested BCG dosages used to treat patients with bladder cancer, and the yearly incidence proportion of BCG infections was computed. A complete medical document review was also undertaken to characterize the clinical characteristics and results of the treated BCG infections.

The key findings of this study were as follow:

1. In all, 87 individuals were diagnosed as having a BCG infection following BCG therapy for bladder cancer.

2. During the latter part of the research period, the incidence proportion progressively climbed, providing a cumulative incidence percentage of 2.5%.

3. BCG infections were associated with considerable mortality, with 10% overall mortality and 17.5% death from systemic infections, both of which were significantly greater than previously documented.

In conclusion, this study emphasizes the potential for infection as a result of BCG therapy, as well as the importance of early diagnosis and intervention of both systemic and local infections.

Reference:

Nurminen, P., Ettala, O., Uusitalo‐Seppälä, R., Nummi, A., Järvinen, R., Antti, K., & Boström, P. J. (2021). Incidence of and mortality from Bacille Calmette‐Guérin (BCG) infections after BCG instillation therapy. In BJU International (Vol. 129, Issue 6, pp. 737–743). Wiley. https://doi.org/10.1111/bju.15608