Tsakiris Dimitrios A, Tichelli André
Department of Haematology, University Hospital Basel, CH-4031 Basel, Switzerland.
Best Pract Res Clin Haematol. 2009 Mar;22(1):137-45. doi: 10.1016/j.beha.2008.12.002.
Haematopoietic stem cell transplantation is currently the only curative option for many haematological malignancies, but is characterized by a wide spectrum of complications, including haemostatic changes. Bleeding and thrombotic events occur in the early and late phases after transplantation. In the early phase, thrombotic events have a variable clinical picture and present either as venous thrombosis, mainly at the site of central venous lines, veno-occlusive disease (also known as sinusoid occlusion syndrome) or transplant-associated microangiopathy. The latter two occur in the context of an acute graft-vs-host reaction, which involves various organs including the endothelium. In the late phase, years or decades after transplantation, thrombotic events present either as common venous thromboses or as arterial occlusions because of the development of premature atherosclerosis combined with diabetes, hypertension and dyslipidaemia, all of which are accelerated under the influence of the post-transplant treatment. This chapter will discuss the incidence, possible causative associations and treatment options of early and late thrombotic events after haematopoietic stem cell transplantation.
造血干细胞移植目前是许多血液系统恶性肿瘤的唯一治愈选择，但具有广泛的并发症，包括止血变化。出血和血栓形成事件发生在移植后的早期和晚期。在早期，血栓形成事件临床表现多样，可表现为静脉血栓形成，主要发生在中心静脉置管部位、静脉闭塞性疾病（也称为窦性阻塞综合征）或移植相关微血管病。后两者发生在急性移植物抗宿主反应的背景下，该反应涉及包括内皮在内的各种器官。在晚期，移植后数年或数十年，由于过早发生动脉粥样硬化并伴有糖尿病、高血压和血脂异常，血栓形成事件可表现为常见的静脉血栓形成或动脉闭塞，所有这些在移植后治疗的影响下都会加速发展。本章将讨论造血干细胞移植后早期和晚期血栓形成事件的发生率、可能的因果关联及治疗选择。
