Department of Medicine, Division of Diabetes, Endocrinology, and Metabolism, Vanderbilt University School of Medicine, Nashville, TN, USA.
Blood. 2010 Aug 26;116(8):1197-204. doi: 10.1182/blood-2010-03-276576. Epub 2010 May 3.
Currently, approximately 15,000 to 20,000 patients undergo allogeneic hematopoietic stem cell transplantation (HSCT) annually throughout the world, with the number of long-term survivors increasing rapidly. In long-term follow-up after transplantation, the focus of care moves beyond cure of the original disease to the identification and treatment of late effects after HSCT. One of the more serious complications is therapy-related cardiovascular disease. Long-term survivors after HSCT probably have an increased risk of premature cardiovascular events. Cardiovascular complications related to dyslipidemia and other risk factors account for a significant proportion of late nonrelapse morbidity and mortality. This review addresses the risk and causes of dyslipidemia and impact on cardiovascular complications after HSCT. Immunosuppressive therapy, chronic graft-versus-host disease, and other long-term complications influence the management of dyslipidemia. There are currently no established guidelines for evaluation and management of dyslipidemia in HSCT patients; in this review, we have summarized our suggested approach in the HSCT population.
目前,全世界每年约有 15000 至 20000 例患者接受异基因造血干细胞移植(HSCT),长期幸存者的数量迅速增加。在移植后的长期随访中,护理的重点不再仅仅是治愈原发病,而是识别和治疗 HSCT 后的晚期效应。其中较为严重的并发症之一是治疗相关性心血管疾病。HSCT 后的长期幸存者可能有过早发生心血管事件的风险。与血脂异常和其他危险因素相关的心血管并发症占晚期非复发发病率和死亡率的很大比例。这篇综述探讨了 HSCT 后血脂异常的风险和原因及其对心血管并发症的影响。免疫抑制治疗、慢性移植物抗宿主病和其他长期并发症影响血脂异常的管理。目前,尚无 HSCT 患者血脂异常评估和管理的既定指南;在这篇综述中,我们总结了我们在 HSCT 人群中的建议方法。