移植后并发症 移植后并发症
Khalid Halahleh1, Yasuyuki Arai2, Eleni Gavriilaki3
1Bone Marrow Transplantation Program and Cell Therapy, King Hussein Cancer Center, Amman, Jordan.
Blood cell therapy
|June 16, 2023
概括
血造细胞移植 (HCT) 可以导致严重的并发症,如移植功能不佳和非传染性肺部并发症. 新的治疗方法正在出现,将以前致命的疾病如移植相关的血栓性微血管病变转化为可管理的综合征.
科学领域:
- 血液学 血液学 血液学
- 免疫学 免疫学 免疫学
- 在瘤学瘤学.
背景情况:
- 造血细胞移植 (HCT) 为高风险疾病提供治疗潜力.
- 移植后的并发症,包括移植功能障碍和非传染性肺部并发症 (NIPCs),存在重大挑战.
- 对于许多HCT并发症的当前治疗选择是不理想的.
研究的目的:
- 审查所有基性HCT (allo-HCT) 后的各种并发症.
- 突出诊断和治疗疾病的挑战,如缺陷移植功能 (PGF) 和NIPCs.
- 讨论治疗严重并发症的进展,如移植相关的血栓性微血管病变 (TA-TMA).
主要方法:
- 对有关异构后HCT并发症的现有文献的综述.
- 对PGF,NIPC和TA-TMA的病理生理学和临床表现的分析.
- 评估当前和新兴的治疗策略,包括新药和补充抑制剂.
主要成果:
- 不良的移植功能影响5-30%的患者,缺乏标准化的治疗指南.
- 非传染性肺部并发症 (NIPC) 的病理生理学定义不清楚,死亡率高 (例如,异常性肺炎综合征>50%).
- 补充抑制剂改善了移植相关的血栓性微血管病变 (TA-TMA) 的结果,此前这是致命的并发症.
结论:
- 异构性HCT与一系列严重并发症有关,需要更好的管理策略.
- 需要进一步的研究来定义和标准化PGF和NIPC的治疗方法.
- 向疗法,如TA-TMA的补充抑制剂,证明了改善移植后护理的潜力.
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