Wollmer E, Neubauer A
Klinik für Hämatologie, Onkologie, Immunologie, Zentrum Innere Medizin, Philipps-Universität Marburg und Universitätsklinikum Gießen und Marburg, Standort Marburg, Baldingerstr. 1, 35033, Marburg, Deutschland,
Internist (Berl). 2014 May;55(5):547-60; quiz 561. doi: 10.1007/s00108-013-3432-3.
Since the 1970s there has been an increase in the number of bone marrow and stem cell transplantations as well as a decrease in transplantation-associated fatalities due to improved transplantation techniques and supportive therapy. Annually nearly 50,000 transplantations are conducted worldwide with matched family grafts and matched or sometimes mismatched unrelated donor grafts. The number of long-term survivors is increasing and the late complications of this relatively aggressive therapy are now becoming apparent. This article is essentially concerned with the delayed complications of bone marrow and stem cell transplantations. Despite curing the malignant primary disease the total survival of transplantation patients is reduced. The main reasons are infection, organ dysfunction and therapy-associated secondary neoplasms. Among the high risk factors are total body irradiation, chronic graft versus host disease as well as treatment during childhood. Guidelines for the follow-up care of these long-term survivors were first published in 2006 and then updated in 2011.
自20世纪70年代以来，随着移植技术和支持治疗的改进，骨髓和干细胞移植的数量有所增加，与移植相关的死亡人数有所减少。全球每年进行近50000例匹配的家族供体移植以及匹配或有时不匹配的无关供体移植。长期存活者的数量在增加，这种相对激进治疗的晚期并发症现在正变得明显。本文主要关注骨髓和干细胞移植的延迟并发症。尽管治愈了原发性恶性疾病，但移植患者的总生存率仍有所降低。主要原因是感染、器官功能障碍和治疗相关的继发性肿瘤。高危因素包括全身照射、慢性移植物抗宿主病以及儿童期治疗。这些长期存活者的随访护理指南于2006年首次发布，并于2011年更新。
