Kanagasundram Sharmilla, Amini Farhanaz
1Department of Psychological Medicine, Faculty of Medicine, University Malaya, 50603 Kuala Lumpur, Malaysia.
School of Healthy Aging, Medical Aesthetics and Regenerative Medicine, University College Sedaya International (UCSI), Jalan Menara Gading 1, Taman Connaught, 56000 Kuala Lumpur, Selangor Malaysia.
Tissue Eng Regen Med. 2018 Sep 6;16(1):1-9. doi: 10.1007/s13770-018-0157-3. eCollection 2019 Feb.
Allogeneic hematopoietic stem cell transplantation (allo-HSCT) can cure leukaemia. However, long term complications of post transplantation interfere with the patients' full recovery. The objective of this review was to identify the various long term complications and to assess their individual prevalences.
Electronic databases including PubMed, Google Scholar and Cochrane were searched for years 2004-2017. The keywords used were leukaemia, allogenic stem cell transplantation, prevalence, side effects, long term, delayed, adverse effects, complications and outcome.
A total of ten articles were included for analysis. There were 5 prospective studies, 3 retrospective studies and 2 cross sectional studies. A total of 40,069 patients, (20,189 males and 17,191 females) participated in these 10 studies. The gender of 2689 patients were not disclosed. Most common late complications and prevalence were chronic graft versus host disease (43% at 5 years post HSCT), secondary tumor (21% at 20 years post HSCT), hypothyroidism (11% at 15 years), bronchiolitis obliterans (9.7% at 122 days), cardiovascular disease (7.5% at 15 years) and avascular necrosis (5.4% at 10 years). The prevalence of azoospermia was 71.1% and depression, 18%. For the latter two conditions no time limit was available. Follow up duration ranged from 2 years till 30 years post HSCT.
While allogenic stem cell transplantation is an effective cure for leukaemia, the procedure is associated with complications that can have their onset many years after the procedure.
异基因造血干细胞移植(allo-HSCT)可治愈白血病。然而,移植后的长期并发症会干扰患者的全面康复。本综述的目的是识别各种长期并发症并评估其个体发生率。
检索了包括PubMed、谷歌学术和考克兰图书馆在内的电子数据库,检索时间为2004年至2017年。使用的关键词有白血病、异基因干细胞移植、发生率、副作用、长期、延迟、不良反应、并发症和结局。
共纳入10篇文章进行分析。其中有5项前瞻性研究、3项回顾性研究和2项横断面研究。这10项研究共有40069名患者参与(男性20189名,女性17191名)。2689名患者的性别未披露。最常见的晚期并发症及发生率为慢性移植物抗宿主病(HSCT后5年为43%)、继发性肿瘤(HSCT后20年为21%)、甲状腺功能减退(15年为11%)、闭塞性细支气管炎(122天为9.7%)、心血管疾病(15年为7.5%)和无血管性坏死(10年为5.4%)。无精子症的发生率为71.1%,抑郁症为18%。对于后两种情况,没有可用的时间限制。HSCT后的随访时间从2年到30年不等。
虽然异基因干细胞移植是治疗白血病的有效方法,但该手术会伴有术后多年才会出现的并发症。