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血红蛋白病造血细胞移植(HCT)后晚期效应筛查指南:第二届儿科血液和骨髓移植国际会议关于儿科 HCT 后晚期效应的共识声明。

Late Effects Screening Guidelines after Hematopoietic Cell Transplantation (HCT) for Hemoglobinopathy: Consensus Statement from the Second Pediatric Blood and Marrow Transplant Consortium International Conference on Late Effects after Pediatric HCT.

机构信息

Washington University School of Medicine, Pediatric Stem Cell Transplant Program, St. Louis Children's Hospital, St. Louis, Missouri.

Meditteranean Institute of Haematology, Rome, Italy.

出版信息

Biol Blood Marrow Transplant. 2018 Jul;24(7):1313-1321. doi: 10.1016/j.bbmt.2018.04.002. Epub 2018 Apr 10.

Abstract

Allogeneic hematopoietic cell transplantation (HCT) can halt organ damage and eliminate symptoms in hemoglobin disorders, including sickle cell disease (SCD) and thalassemia major. Managing the residual manifestations of pre-HCT disease complications and the long-term effects of HCT requires systematic monitoring, follow-up and intervention when indicated. Late complications vary with age and disease status at HCT and with transplant variables such as preparative regimen, donor source and compatibility, and immune reconstitution. An international consensus conference sponsored by the Pediatric Blood and Marrow Transplant Consortium in May 2016 entitled "Late Effects Screening and Recommendations Following HCT for Immune Deficiency and Nonmalignant Hematologic Disorders" focused on follow-up after HCT for hemoglobinopathy. An earlier publication from experts who participated in this session described the pathophysiology and spectrum of complications that HCT recipients experience after HCT for SCD and thalassemia major. This companion publication summarizes the consensus reached by this group of experts about long-term follow-up guidelines after HCT for hemoglobinopathy. In addition, these guidelines might also be included in studies of novel curative therapies such as autologous HCT after hematopoietic progenitor stem cell gene modification.

摘要

异基因造血细胞移植 (HCT) 可阻止血红蛋白疾病(包括镰状细胞病[SCD]和重型地中海贫血)中的器官损伤和消除症状。管理 HCT 前疾病并发症的残留表现和 HCT 的长期影响需要系统监测、随访和有指征时的干预。迟发性并发症随 HCT 时的年龄和疾病状态以及移植变量(如预处理方案、供体来源和相容性以及免疫重建)而变化。2016 年 5 月,由儿科血液和骨髓移植联盟主办的一次国际共识会议题为“免疫缺陷和非恶性血液系统疾病 HCT 后的迟发性并发症筛查和建议”,重点关注血红蛋白病 HCT 后的随访。来自参加本次会议的专家的早期出版物描述了 HCT 治疗 SCD 和重型地中海贫血后 HCT 受者经历的发病机制和并发症谱。本随刊综述总结了该专家组关于血红蛋白病 HCT 后长期随访指南的共识。此外,这些指南也可能包含在新型治疗方法(如造血祖细胞基因修饰后的自体 HCT)的研究中。

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