Barton-Burke Margaret, Dwinell Debra M, Kafkas Linda, Lavalley Candice, Sands Hillary, Proctor Courtney, Johnson Elizabeth
College of Nursing, University of Missouri-St. Louis, USA.
Oncology (Williston Park). 2008 Oct;22(11 Suppl Nurse Ed):31-45.
Hematopoietic stem cell transplantation (HSCT)/bone marrow transplantation (BMT) has become a central treatment modality in the management of various hematologic malignancies, but it is not without treatment sequelae. The major complication of HSCT/BMT is acute or chronic graft-versus-host disease (GVHD). GVHD is an immunologically mediated disease that contributes substantially to transplant-related morbidity and mortality. The overall incidence of GVHD remains between 30% and 60% and carries approximately a 50% mortality rate. Acute and chronic GVHD are complex clinical phenomena. This paper focuses on our current clinical understanding of GVHD as a multiphase process intricately linked to the immune response between the donor (graft) and recipient (host). Based on this complex pathophysiology, clinical nursing care is targeted at the various body systems affected by either acute or chronic GVHD. The article concludes with advances and clinical trials underway that have the potential to reduce the symptomatology of GVHD.
造血干细胞移植（HSCT）/骨髓移植（BMT）已成为各种血液系统恶性肿瘤治疗的核心方式，但并非没有治疗后遗症。HSCT/BMT的主要并发症是急性或慢性移植物抗宿主病（GVHD）。GVHD是一种免疫介导的疾病，在很大程度上导致了移植相关的发病率和死亡率。GVHD的总体发病率仍在30%至60%之间，死亡率约为50%。急性和慢性GVHD是复杂的临床现象。本文重点阐述了我们目前对GVHD作为一个与供体（移植物）和受体（宿主）之间免疫反应复杂相关的多阶段过程的临床理解。基于这种复杂的病理生理学，临床护理针对受急性或慢性GVHD影响的各个身体系统。文章最后介绍了正在进行的有可能减轻GVHD症状的进展和临床试验。
