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异基因造血干细胞移植后中枢神经系统相关移植物抗宿主病。

Central Nervous System-related Graft-versus-host Disease after Allogeneic Hematopoietic Stem Cell Transplantation.

机构信息

Department of Hematology, Nippon Medical School, Japan.

Department of Diagnostic Pathology, Nippon Medical School Hospital, Japan.

出版信息

Intern Med. 2021;60(20):3299-3304. doi: 10.2169/internalmedicine.6351-20. Epub 2021 Oct 15.

Abstract

Allogeneic hemopoietic stem cell transplantation (allo-HSCT) is the only curative therapy for refractory hematological malignancies. However, there are many treatment-related complications, including organ disorders, graft-versus-host disease (GVHD), and infectious diseases. Furthermore, there are many unclear points regarding central nervous system (CNS) complications, and the prognosis in patients with CNS complications is extremely poor. We herein report a 49-year-old woman who developed CNS-GVHD after a second transplantation for therapy-related myelodysplastic syndrome. CNS-GVHD in this case was refractory to all treatments, including steroids, and progressed. We also present a review of the literature about the symptoms, diagnosis, and treatment of CNS-GVHD.

摘要

异基因造血干细胞移植(allo-HSCT)是治疗难治性血液系统恶性肿瘤的唯一根治性疗法。然而,有许多与治疗相关的并发症,包括器官障碍、移植物抗宿主病(GVHD)和传染病。此外,中枢神经系统(CNS)并发症有许多不清楚的地方,CNS 并发症患者的预后极差。我们在此报告一例 49 岁女性,因治疗相关骨髓增生异常综合征行第二次移植后发生中枢神经系统-GVHD。该例 CNS-GVHD 对包括类固醇在内的所有治疗均耐药且进展。我们还对 CNS-GVHD 的症状、诊断和治疗进行了文献复习。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b3a2/8580761/1c1bf2a4a686/1349-7235-60-3299-g001.jpg

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