Fred Hutchinson Cancer Research Center, Seattle, WA 98109-1024, USA.
J Clin Oncol. 2012 Oct 20;30(30):3746-51. doi: 10.1200/JCO.2012.42.3038. Epub 2012 Sep 24.
This review highlights long-term and late consequences of hematopoietic cell transplantation (HCT) as well as strategies to manage or prevent complications that are more prevalent after HCT than most other cancer treatments. Chronic graft-versus-host disease stands out as a unique late effect of allogeneic HCT that is not seen after other types of cancer treatment. However, many other complications seen after solid tumor treatments are also common after HCT, including infections, second cancers, bone loss, and cardiovascular, pulmonary, renal, and endocrine dysfunction. Symptoms and syndromes that are reported after HCT include sexual dysfunction, cognitive problems, fatigue, insomnia, musculoskeletal symptoms, emotional distress, anger, and depression. Addressing these complex potential or actual complications requires diligent routine health care to intervene early or, when possible, to prevent late complications. To accomplish early detection and prevention of life-threatening complications, HCT survivors should undergo an annual comprehensive physical examination that includes screening for functional and psychosocial consequences of treatment and encouraging healthy lifestyle behaviors. Clinicians can link survivors to numerous online, print, and video resources to help them advocate for their health needs.
这篇综述重点介绍了造血细胞移植（HCT）的长期和晚期后果，以及管理或预防并发症的策略，这些并发症在 HCT 后比大多数其他癌症治疗更为常见。慢性移植物抗宿主病是同种异体 HCT 的一种独特的晚期效应，在其他类型的癌症治疗后不会出现。然而，许多在实体瘤治疗后出现的其他并发症在 HCT 后也很常见，包括感染、第二癌症、骨质流失以及心血管、肺、肾和内分泌功能障碍。HCT 后报告的症状和综合征包括性功能障碍、认知问题、疲劳、失眠、肌肉骨骼症状、情绪困扰、愤怒和抑郁。解决这些复杂的潜在或实际并发症需要进行勤奋的常规保健，以便早期干预或在可能的情况下预防晚期并发症。为了实现对危及生命的并发症的早期检测和预防，HCT 幸存者应每年进行全面体检，包括筛查治疗的功能和社会心理后果，并鼓励健康的生活方式行为。临床医生可以将幸存者与众多在线、印刷和视频资源联系起来，以帮助他们倡导自己的健康需求。
