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异基因造血细胞移植受者的感染并发症:移植相关危险因素的回顾与当前预防策略。

Infectious complications in allogeneic hematopoietic cell transplant recipients: Review of transplant-related risk factors and current state of prophylaxis.

机构信息

Department of Bone Marrow Transplantation, National Hematology Research Center, Moscow, Russian Federation.

出版信息

Clin Transplant. 2021 Feb;35(2):e14172. doi: 10.1111/ctr.14172. Epub 2020 Dec 12.

Abstract

Allogeneic hematopoietic cell transplantation is a complex procedure that carries a significant risk of complications. Infections are among the most common of them. Several direct factors such as neutropenia, hypogammaglobulinemia, lymphopenia, mucosal barrier injury, and graft-versus-host disease have been shown to be associated with increased infectious risk post-transplant. Apart from direct factors, there are also indirect transplant-related factors that are the primary trigger to the formers' development. The most important of them are type of preparative regimen, graft source, donor type, graft-versus-host disease prophylaxis, and graft manipulation techniques. In this review, an attempt has been made to summarize the role of the transplant-related factors in the development of infectious complications and provide evidence underlying the current concept of infectious disease prophylaxis in patients after allogeneic hematopoietic cell transplantation.

摘要

异基因造血细胞移植是一种复杂的程序,有发生并发症的重大风险。感染是最常见的并发症之一。多项直接因素,如中性粒细胞减少、低丙种球蛋白血症、淋巴细胞减少、黏膜屏障损伤和移植物抗宿主病,已被证明与移植后感染风险增加有关。除了直接因素外,还有间接的移植相关因素,它们是导致前者发展的主要原因。其中最重要的是预处理方案的类型、移植物来源、供者类型、移植物抗宿主病预防和移植物处理技术。在这篇综述中,我们试图总结移植相关因素在感染并发症发展中的作用,并为异基因造血细胞移植后患者感染性疾病预防的现有概念提供依据。

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