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自体干细胞移植后的植入综合征:统一定义和管理方法的最新进展

Engraftment Syndrome after Autologous Stem Cell Transplantation: An Update Unifying the Definition and Management Approach.

作者信息

Cornell Robert Frank, Hari Parameswaran, Drobyski William R

机构信息

Division of Hematology and Oncology, Department of Internal Medicine, Vanderbilt University Medical Center, Nashville, Tennessee.

Division of Hematology and Oncology, Department of Internal Medicine, The Medical College of Wisconsin, Milwaukee, Wisconsin.

出版信息

Biol Blood Marrow Transplant. 2015 Dec;21(12):2061-2068. doi: 10.1016/j.bbmt.2015.08.030. Epub 2015 Aug 29.

Abstract

Engraftment syndrome (ES) encompasses a continuum of periengraftment complications after autologous hematopoietic stem cell transplantation. ES may include noninfectious fever, skin rash, diarrhea, hepatic dysfunction, renal dysfunction, transient encephalopathy, and capillary leak features, such as noncardiogenic pulmonary infiltrates, hypoxia, and weight gain with no alternative etiologic basis other than engraftment. Given its pleiotropic clinical presentation, the transplant field has struggled to clearly define ES and related syndromes. Here, we present a comprehensive review of ES in all documented disease settings. Furthermore, we discuss the proposed risk factors, etiology, and clinical relevance of ES. Finally, our current approach to ES is included along with a proposed treatment algorithm for the management of this complication.

摘要

植入综合征(ES)包括自体造血干细胞移植后一系列植入期并发症。ES可能包括非感染性发热、皮疹、腹泻、肝功能障碍、肾功能障碍、短暂性脑病以及毛细血管渗漏特征,如非心源性肺浸润、缺氧和体重增加,且除植入外无其他病因。鉴于其多效性临床表现,移植领域一直难以明确界定ES及相关综合征。在此,我们对所有已记录疾病背景下的ES进行全面综述。此外,我们还讨论了ES的潜在危险因素、病因及临床相关性。最后,介绍了我们目前针对ES的处理方法以及针对该并发症管理的建议治疗方案。

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