Patzik S B, Smith C, Kubicka R A, Kaizer H
Department of Diagnostic Radiology and Nuclear Medicine, Rush-Presbyterian-St Luke's Medical Center, Chicago, IL 60612.
Radiographics. 1991 Jul;11(4):601-10. doi: 10.1148/radiographics.11.4.1887115.
With the advent of histocompatibility typing, use of bone marrow transplantation for treating hematogenous cancer has dramatically increased. Marrow grafting is preceded by intense immunosuppressive, marrow ablative treatment, usually with high-dose chemotherapy and whole-body irradiation. Because the recipient may be immunocompromised for months after transplantation due to this regimen, complications are numerous. Complications are classified according to the following intervals: pre-engraftment (from pretransplantation treatment to engraftment), postengraftment (3 months afterward), and delayed (longer than 3 months after engraftment). Pre-engraftment complications include bacterial, fungal, and viral infections; tissue-damaging effects (eg, toxic pneumonitis); hepatic veno-occlusive disease; and graft rejection. Postengraftment complications include viral, fungal, and protozoal infections; acute graft-versus-host disease (GVHD); and pneumatosis intestinalis. Delayed complications include chronic GVHD and recurrence of cancer. As part of the follow-up team, radiologists should be familiar with clinical aspects of marrow transplantation and be alert for early, potential life-threatening complications.
随着组织相容性分型技术的出现，骨髓移植在治疗血源性癌症方面的应用显著增加。在进行骨髓移植之前，通常会采用大剂量化疗和全身照射等强烈的免疫抑制、骨髓清除治疗。由于这种治疗方案，受者在移植后可能会有几个月的免疫功能低下，因此并发症众多。并发症可根据以下时间段进行分类：植入前（从移植前治疗到植入）、植入后（此后3个月内）和延迟期（植入后超过3个月）。植入前并发症包括细菌、真菌和病毒感染；组织损伤效应（如中毒性肺炎）；肝静脉闭塞病；以及移植排斥反应。植入后并发症包括病毒、真菌和原生动物感染；急性移植物抗宿主病（GVHD）；以及肠壁囊样积气症。延迟并发症包括慢性GVHD和癌症复发。作为随访团队的一员，放射科医生应熟悉骨髓移植的临床情况，并警惕早期可能危及生命的并发症。
