Blood and Marrow Transplant Program, Department of Pediatrics, C.S. Mott Children's Hospital, University of Michigan, Ann Arbor, MI 48109, USA.
Br J Haematol. 2013 Feb;160(3):288-302. doi: 10.1111/bjh.12142. Epub 2012 Dec 4.
Acute graft-versus-host disease (GVHD) is a leading cause of non-relapse mortality following allogeneic haematopoietic cell transplantation. Attempts to improve treatment response in clinically-established GVHD have not improved overall survival, often due to the increased risk of infectious complications. Alternative approaches to decrease GVHD-related morbidity and mortality have focused on the ability to predict GVHD prior to clinical manifestation in an effort to provide an opportunity to abort GVHD development, and to gain new insights into GVHD pathophysiology. This review outlines the research efforts to date that have identified clinical and laboratory-based factors that are predictive of acute GVHD and describes future directions in developing algorithms that will improve the ability to predict the development of clinically relevant GVHD.
急性移植物抗宿主病(GVHD)是异基因造血细胞移植后非复发死亡的主要原因。尽管尝试改善临床确诊的 GVHD 治疗反应,但并未改善总体生存率,这通常是由于感染并发症风险增加所致。减少 GVHD 相关发病率和死亡率的替代方法侧重于在临床症状出现之前预测 GVHD 的能力,以提供中止 GVHD 发展的机会,并深入了解 GVHD 病理生理学。本综述概述了迄今为止确定可预测急性 GVHD 的临床和实验室因素的研究工作,并描述了开发算法以提高预测临床相关 GVHD 发展能力的未来方向。