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[皮肤移植物抗宿主病]

[Cutaneous graft-versus-host disease].

作者信息

Karrer S

机构信息

Klinik und Poliklinik für Dermatologie, Universität Regensburg.

出版信息

Hautarzt. 2003 May;54(5):465-80; quiz 481-2. doi: 10.1007/s00105-003-0528-z.

Abstract

Although stem cell transplantation is a life-saving measure and the treatment of choice for many patients with various hematologic malignancies, a high incidence of complications and a transplantation associated mortality of about 30% are to be expected.Graft-versus-Host Disease (GvHD) is the major cause of morbidity and mortality after stem cell transplantation. GvHD can arise at various time points. Acute GvHD occurs during the first 100 days after transplantation in up to 50% of graft recipients, while chronic GvHD develops in about 30-50% usually within 100-500 days following allogeneic stem cell transplantation. It can involve the skin, liver, gastrointestinal tract, and less frequently the lungs, eyes and neuromuscular system. Early diagnosis of GvHD can be difficult, as drug reactions, viral infections and cutaneous reactions to radiation therapy may have clinical and histological similarities. In this review, the various cutaneous manifestations of GvHD, the histopathologic features, prophylaxis and therapy of acute and chronic GvHD are discussed in light of the recent literature.

摘要

尽管干细胞移植是一项挽救生命的措施,也是许多各种血液系统恶性肿瘤患者的首选治疗方法,但预计并发症的发生率较高,且与移植相关的死亡率约为30%。移植物抗宿主病(GvHD)是干细胞移植后发病和死亡的主要原因。GvHD可在不同时间点出现。急性GvHD发生在移植后的前100天内,高达50%的移植受者会出现,而慢性GvHD通常在异基因干细胞移植后的100 - 500天内发生,约30 - 50%的患者会出现。它可累及皮肤、肝脏、胃肠道,较少累及肺、眼睛和神经肌肉系统。GvHD的早期诊断可能困难,因为药物反应、病毒感染和放疗后的皮肤反应可能在临床和组织学上有相似之处。在本综述中,根据最近的文献讨论了GvHD的各种皮肤表现、急性和慢性GvHD的组织病理学特征、预防和治疗。

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