Ma S Y, Au W Y, Lie A K W, Ng I O L, Leung A Y H, Tse E W, Liang R H, Lau G K, Kwong Y L
Department of Medicine, University of Hong Kong, Queen Mary Hospital, Hong Kong.
Bone Marrow Transplant. 2004 Jul;34(1):57-61. doi: 10.1038/sj.bmt.1704522.
Graft-versus-host disease (GVHD) is the commonest complication after donor lymphocyte infusion (DLI). In 19 patients undergoing DLI for relapses of hematologic malignancies post hematopoietic stem cell transplantation (HSCT), 11 developed GVHD, of whom nine had isolated liver involvement, and two had liver and skin involvement. The clinical diagnosis of liver GVHD was hepatitic in six patients (55%) and classical in five patients (45%). Patients with GVHD post-DLI showed a different clinical pattern when compared to a cohort of 106 cases of GVHD post-HSCT, in having significantly more isolated liver involvement (9/11 vs 17/106, P<0.001), and less skin (2/11 vs 80/106, P<0.001) and gut (0/11 vs 28/106, P<0.001) involvement. However, liver GVHD post-DLI and post-HSCT had comparable patient characteristics, underlying diseases, clinical subtypes (classical and hepatitic) and response to treatment.
移植物抗宿主病(GVHD)是供体淋巴细胞输注(DLI)后最常见的并发症。在19例因造血干细胞移植(HSCT)后血液系统恶性肿瘤复发而接受DLI的患者中,11例发生了GVHD,其中9例仅有肝脏受累,2例有肝脏和皮肤受累。肝GVHD的临床诊断中,6例(55%)为肝炎型,5例(45%)为典型型。与106例HSCT后GVHD患者队列相比,DLI后GVHD患者表现出不同的临床模式,肝脏单独受累明显更多(9/11 vs 17/106,P<0.001),皮肤(2/11 vs 80/106,P<0.001)和肠道(0/11 vs 28/106,P<0.001)受累更少。然而,DLI后和HSCT后的肝GVHD在患者特征、基础疾病、临床亚型(典型型和肝炎型)及治疗反应方面具有可比性。