口腔移植物抗宿主病
Oral graft-versus-host disease.
作者信息
Imanguli M M, Alevizos I, Brown R, Pavletic S Z, Atkinson J C
机构信息
Experimental Transplantation and Immunology Branch, Center for Cancer Research, National Cancer Institute, Bethesda, Maryland, USA.
出版信息
Oral Dis. 2008 Jul;14(5):396-412. doi: 10.1111/j.1601-0825.2008.01448.x.
OBJECTIVE
Graft-versus-host disease (GVHD) is a leading cause of morbidity and mortality in patients receiving hematopoietic cell transplant. It is estimated that 40-70% of engrafted patients surviving the initial transplant eventually develop chronic GVHD (cGVHD), which can persist for months to years and require long-term management from multiple disciplines. This review describes the oral component of this transplant complication.
DESIGN
The search related to GVHD patho-biology, salivary gland disease after hematopoietic cell transplant and treatments for oral GVHD encompassed literature from 1966 through 2008. Searches were limited to the MEDLINE/PubMed database and English language literature in peer-reviewed journals.
RESULTS
Our understanding of the patho-biology of oral cGVHD is based on studies of other affected tissues. It is difficult to determine the prevalence and incidence of salivary gland disease after transplant because there is no universally accepted case definition. In general, clinical trials for treatment of oral cGVHD have been too small to make strong recommendations for use in clinical practice.
CONCLUSIONS
Larger well-designed clinical studies are needed to understand the patho-biology of oral cGVHD and determine best treatments for this disease.
目的
移植物抗宿主病（GVHD）是接受造血细胞移植患者发病和死亡的主要原因。据估计，在初次移植后存活的植入患者中，40%-70%最终会发展为慢性GVHD（cGVHD），这种疾病可持续数月至数年，需要多学科的长期管理。本综述描述了这种移植并发症的口腔部分。
设计
与GVHD病理生物学、造血细胞移植后的涎腺疾病以及口腔GVHD治疗相关的检索涵盖了1966年至2008年的文献。检索仅限于MEDLINE/PubMed数据库以及同行评审期刊中的英文文献。
结果
我们对口腔cGVHD病理生物学的理解基于对其他受累组织的研究。由于没有普遍接受的病例定义，很难确定移植后涎腺疾病的患病率和发病率。一般来说，治疗口腔cGVHD的临床试验规模太小，无法为临床实践中的应用提出有力建议。
结论
需要进行更大规模、设计良好的临床研究，以了解口腔cGVHD的病理生物学并确定该疾病的最佳治疗方法。
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