Clark C A, Savani M, Mohty M, Savani B N
Department of Internal Medicine, Hematology and Stem Cell Transplant Section, Vanderbilt University Medical Center, Nashville, TN, USA.
The University of Tennessee Heath Science Center, College of Medicine, Memphis, TN, USA.
Bone Marrow Transplant. 2016 Aug;51(8):1025-31. doi: 10.1038/bmt.2016.95. Epub 2016 Apr 11.
Allogeneic hematopoietic stem cell transplantation (allo-HSCT) is a potentially curative treatment for over 70 benign and malignant hematologic and immunological processes. Over the past several decades, significant technological and post-transplant supportive advances have been made, resulting in a decrease in early transplant mortality and continued growth in the population of allo-HSCT survivors. With the expansion in the number of long-term survivors, as well as of those considering a transplant, the focus of transplant medicine has been shifted significantly to include a more prominent role for the care of the 'long-term' survivor. These patients have survived the acute critical phase of transplantation and have potentially achieved remission from their primary disease, yet allo-HSCT patients do not return to pre-transplant health status. For survivors >2 years removed, the time of transplant all-cause mortality is four- to nine-fold higher than age-matched peers within the general population. These patients represent a distinct, high-risk population that must be monitored for long-term transplant complications, including chronic GvHD (cGvHD), multi-organ dysfunctions and secondary malignancies. This article will review in a non-exhaustive manner, the approach to long-term care of an allo-HSCT recipient.
异基因造血干细胞移植（allo-HSCT）是一种对70多种良性和恶性血液及免疫性疾病具有潜在治愈作用的治疗方法。在过去几十年中，技术和移植后支持治疗取得了重大进展，导致早期移植死亡率下降，allo-HSCT幸存者数量持续增加。随着长期幸存者以及考虑进行移植的人数的增加，移植医学的重点已显著转移，将对“长期”幸存者的护理纳入更突出的角色。这些患者已度过移植的急性关键期，可能已从原发性疾病中缓解，但allo-HSCT患者并未恢复到移植前的健康状态。对于移植后超过2年的幸存者，移植后的全因死亡率比普通人群中年龄匹配的同龄人高4至9倍。这些患者是一个独特的高风险人群，必须对其长期移植并发症进行监测，包括慢性移植物抗宿主病（cGvHD）、多器官功能障碍和继发性恶性肿瘤。本文将以非详尽的方式回顾allo-HSCT受者的长期护理方法。
