Astashchanka Anna, Ryan Joseph, Lin Erica, Nokes Brandon, Jamieson Catriona, Kligerman Seth, Malhotra Atul, Mandel Jess, Joshua Jisha
Division of Pulmonary, Critical Care, Sleep Medicine, and Physiology, University of California San Diego, La Jolla, CA 92121, USA.
Division of Hematology & Oncology, Scripps Clinic, La Jolla, CA 92037, USA.
J Clin Med. 2021 Jul 22;10(15):3227. doi: 10.3390/jcm10153227.
Hematopoietic stem cell transplants (HSCT) are becoming more widespread as a result of optimization of conditioning regimens and prevention of short-term complications with prophylactic antibiotics and antifungals. However, pulmonary complications post-HSCT remain a leading cause of morbidity and mortality and are a challenge to clinicians in both diagnosis and treatment. This comprehensive review provides a primer for non-pulmonary healthcare providers, synthesizing the current evidence behind common infectious and non-infectious post-transplant pulmonary complications based on time (peri-engraftment, early post-transplantation, and late post-transplantation). Utilizing the combination of timing of presentation, clinical symptoms, histopathology, and radiographic findings should increase rates of early diagnosis, treatment, and prognostication of these severe illness states.
由于预处理方案的优化以及预防性使用抗生素和抗真菌药物预防短期并发症，造血干细胞移植（HSCT）正变得越来越普遍。然而，HSCT后的肺部并发症仍然是发病和死亡的主要原因，并且在诊断和治疗方面对临床医生构成挑战。这篇综述为非肺部医疗服务提供者提供了一份入门指南，基于时间（植入期、移植早期和移植后期）综合了常见的移植后感染性和非感染性肺部并发症背后的现有证据。利用临床表现的时间、临床症状、组织病理学和影像学检查结果相结合的方法，应能提高这些严重疾病状态的早期诊断、治疗和预后评估率。
