Atilla Erden, Atilla Pinar Ataca, Toprak Selami Kocak, Demirer Taner
Department of Hematology, Ankara University Medical School, Ankara, Turkey.
Clin Transplant. 2017 Oct;31(10). doi: 10.1111/ctr.13062. Epub 2017 Aug 21.
Allogeneic hematopoietic stem cell transplantation (allo-HSCT) is an effective and curative treatment of different malignant and non-malignant diseases. Early transplant-related mortality after allo-HSCT has decreased with reduced-intensity conditioning regimens and effective anti-infectious treatments, but late transplant-related mortality is still a problem. Physicians are now paying more attention to late complications that may worsen the quality of life of many transplant recipients. Chronic graft versus host disease (cGVHD) is one of the major causes of late transplant-related mortality after allo-HSCT. This review discusses recent advances that have been made in clinical evaluation and treatment of late transplant-related complications including cGVHD. The different sites of involvement are organs, especially the skin and eye, and the gastrointestinal, endocrinologic, metabolic, renal, cardiologic, pulmonary, connective tissue, and neurological systems. In addition, this review includes infections and secondary malignancies in post-transplant settings that worsen quality of life in long-term follow-ups.
异基因造血干细胞移植（allo-HSCT）是治疗多种恶性和非恶性疾病的一种有效且可治愈的方法。随着减低强度预处理方案和有效的抗感染治疗，allo-HSCT术后早期移植相关死亡率有所下降，但晚期移植相关死亡率仍然是一个问题。医生们现在更加关注可能会恶化许多移植受者生活质量的晚期并发症。慢性移植物抗宿主病（cGVHD）是allo-HSCT术后晚期移植相关死亡的主要原因之一。本综述讨论了在包括cGVHD在内的晚期移植相关并发症的临床评估和治疗方面取得的最新进展。受累的不同部位包括器官，尤其是皮肤和眼睛，以及胃肠道、内分泌、代谢、肾脏、心脏、肺、结缔组织和神经系统。此外，本综述还包括移植后环境中的感染和继发性恶性肿瘤，这些在长期随访中会恶化生活质量。
