Mohty Mohamad, Malard Florent, Savani Bipin N
Department of Haematology, Saint Antoine Hospital, Paris, France; INSERM UMR 938, Paris, France; Université Pierre et Marie Curie, Paris, France.
Department of Haematology, Saint Antoine Hospital, Paris, France; INSERM UMR 938, Paris, France; Université Pierre et Marie Curie, Paris, France.
Biol Blood Marrow Transplant. 2015 Apr;21(4):620-4. doi: 10.1016/j.bbmt.2014.09.010. Epub 2014 Sep 20.
Over the last decade, the care of patients undergoing allogeneic hematopoietic cell transplantation (allo-HCT) has significantly improved, leading to a decrease in deaths related to allo-HCT as well as improved long-term survival. However, for many patients, long-term survivorship is associated with a substantial burden of chronic morbidities. Indeed, malignant and nonmalignant late complications after allo-HCT are numerous and usually multifactorial, with all organs and tissues a potential target. In many cases, these long-term side effects are associated with the use of high-dose total body irradiation, myeloablative conditioning regimens, and the onset of chronic graft-versus-host disease. It appears to be essential to change the natural history of these late effects. This requires the introduction of improved conditioning regimens and the development of lifelong monitoring controls, patient counseling, and preventative treatment measures. This approach will allow us to pursue our efforts to improve patient outcome.
在过去十年中，接受异基因造血细胞移植（allo-HCT）患者的护理有了显著改善，导致与allo-HCT相关的死亡人数减少，长期生存率提高。然而，对许多患者来说，长期生存伴随着大量慢性疾病负担。事实上，allo-HCT后的恶性和非恶性晚期并发症众多，通常是多因素的，所有器官和组织都是潜在靶点。在许多情况下，这些长期副作用与高剂量全身照射、清髓性预处理方案以及慢性移植物抗宿主病的发生有关。改变这些晚期效应的自然病程似乎至关重要。这需要引入改进的预处理方案，并制定终身监测控制、患者咨询和预防性治疗措施。这种方法将使我们能够继续努力改善患者预后。
