Akpek G
Blood and Marrow Transplantation Program, Greenbaum Cancer Center, Baltimore, MD 21201, USA.
Bone Marrow Transplant. 2006 Nov;38(10):653-6. doi: 10.1038/sj.bmt.1705504. Epub 2006 Sep 25.
The optimum graft-versus-host disease (GVHD) management in today's clinical practice remains controversial. There is an enormous heterogeneity among transplanters in their therapeutic decisions for each individual patient with GVHD. Existing guidelines do not always cover many unique clinical scenarios. Consequently, a significant number of allograft recipients fail either because of severe GVHD or relapse of underlying malignancy. Until more effective methods are available, tailoring the current GVHD management by modification of immunosuppressive therapy in each patient based on disease and transplant characteristics may decrease the mortality. The purpose of this review is to raise several questions among readers about GVHD management and generate new hypotheses, which may need to be tested in cooperative group studies.
在当今临床实践中，移植物抗宿主病（GVHD）的最佳管理仍存在争议。对于每一位患有GVHD的个体患者，移植医生在治疗决策上存在巨大差异。现有指南并不总能涵盖许多独特的临床情况。因此，相当数量的同种异体移植受者要么因严重的GVHD，要么因潜在恶性肿瘤复发而失败。在有更有效方法可用之前，根据疾病和移植特征对每位患者的免疫抑制治疗进行调整，以定制当前的GVHD管理，可能会降低死亡率。本综述的目的是向读者提出几个关于GVHD管理的问题，并提出新的假设，这些假设可能需要在合作组研究中进行检验。
