Department of Hematology, Osaka International Cancer Institute, Osaka, Japan.
Hematology and Stem Cell Transplantation Section, Division of Hematology/Oncology, Department of Medicine, Vanderbilt University Medical Center and Veterans Affairs Medical Center, Nashville, TN, USA.
Bone Marrow Transplant. 2021 Jun;56(6):1248-1256. doi: 10.1038/s41409-020-01205-6. Epub 2021 Jan 29.
Allogeneic hematopoietic cell transplantation (allo-HCT) is a potentially curative treatment for patients with a hematologic disease. Although the clinical outcomes after allo-HCT have significantly improved during the last few decades, graft-versus-host disease (GVHD) is still a major cause of post-HCT morbidity and mortality. Systemic glucocorticoids (GC) remain an integral part of treatment in patients with GVHD including both acute and chronic GVHD. Although it is well-known that usage of systemic GC is associated with various side effects, the short- and long-term effects of GCs in the HCT setting are not well-characterized due to limited published data. In order to clarify this issue, we summarize the information on side effects associated with GCs, focusing specifically on the sequelae of these agents in the early post-HCT period. In instances where limited data are available, we included data from other fields such as autoimmune diseases, given the potential parallels between autoimmune conditions and GVHD.
异基因造血细胞移植（allo-HCT）是治疗血液系统疾病患者的一种潜在治愈方法。尽管在过去几十年中，allo-HCT 的临床结果有了显著改善，但移植物抗宿主病（GVHD）仍然是移植后发病率和死亡率的主要原因。全身性糖皮质激素（GC）仍然是治疗包括急性和慢性 GVHD 在内的 GVHD 患者的重要组成部分。尽管众所周知，全身性 GC 的使用与各种副作用有关，但由于发表的数据有限，GC 在 HCT 环境中的短期和长期影响尚未得到很好的描述。为了解决这个问题，我们总结了与 GC 相关的副作用信息，特别关注这些药物在移植后早期的后遗症。在数据有限的情况下，我们还纳入了来自自身免疫性疾病等其他领域的数据，因为自身免疫性疾病与 GVHD 之间存在潜在的相似性。
