Busmail Alberto, Penumetcha Sai Sri, Ahluwalia Saher, Irfan Rejja, Khan Sawleha Arshi, Rohit Reddy Sai, Vasquez Lopez Maria Elisa, Zahid Maryam, Mohammed Lubna
Internal Medicine, California Institute of Behavioral Neurosciences & Psychology, Fairfield, USA.
Research, California Institute of Behavioral Neurosciences & Psychology, Fairfield, USA.
Cureus. 2022 May 7;14(5):e24807. doi: 10.7759/cureus.24807. eCollection 2022 May.
The main purpose of this systematic review was to identify and synthesize evidence about pulmonary complications following stem cell transplantation to raise awareness among physicians since it is a lesser-known topic. Studies that included targeted pulmonary complications that occurred after stem cell transplantation; in humans; and were randomized controlled trials, cohort studies, and case studies between January 2011 and 2021. Fifteen intervention features were identified and analyzed in terms of their association with successful or unsuccessful interventions. Fifteen of 15 studies that met inclusion criteria had positive results. Features that appeared to have the most consistent positive effects included relevant information consisting of clinical presentations and management of complications. Hematopoietic stem cell transplantation is a therapeutic method that has been introduced for various hematological diseases. Its main objective is to restore the hematopoietic function that has been eradicated or affected. The stem cell transplantation requires a period of administration of chemotherapeutic agents that may lead to infectious and/or non-infectious pulmonary complications that require follow-up. Noninfectious pulmonary complications include bronchiolitis obliterans, alveolar hemorrhage, fibroelastosis, pulmonary hypertension, and infections. Bronchiolitis obliterans syndrome is an obstructive lung disease that affects the small airways, reducing lung function, and it's the most frequent late-onset complication. Furthermore, diffuse pulmonary hemorrhage is a fatal adverse effect and the most common noninfectious pulmonary complication of acute leukemia, observed within the first weeks after the procedure. Pulmonary hypertension has multiple etiologies, mainly related to the pulmonary veno-occlusive disease. It carries a poor prognosis, with a 55% mortality rate. The area of hematology is very wide and prone to new development of treatments and procedures that could be available for new emerging diseases and improving survival rates.
本系统评价的主要目的是识别和综合关于干细胞移植后肺部并发症的证据，以提高医生的认识，因为这是一个鲜为人知的话题。纳入的研究包括2011年1月至2021年期间在人类中进行的、关于干细胞移植后发生的针对性肺部并发症的随机对照试验、队列研究和病例研究。确定了15个干预特征，并分析了它们与成功或不成功干预的关联。符合纳入标准的15项研究均有阳性结果。似乎具有最一致积极效果的特征包括由并发症的临床表现和管理组成的相关信息。造血干细胞移植是一种针对各种血液疾病引入的治疗方法。其主要目标是恢复已被根除或受影响的造血功能。干细胞移植需要一段化疗药物给药期，这可能导致需要随访的感染性和/或非感染性肺部并发症。非感染性肺部并发症包括闭塞性细支气管炎、肺泡出血、纤维弹性组织增生、肺动脉高压和感染。闭塞性细支气管炎综合征是一种影响小气道的阻塞性肺病，会降低肺功能，是最常见的迟发性并发症。此外，弥漫性肺出血是一种致命的不良反应，是急性白血病最常见的非感染性肺部并发症，在手术后的头几周内观察到。肺动脉高压有多种病因，主要与肺静脉闭塞性疾病有关。其预后较差，死亡率为55%。血液学领域非常广泛，容易出现可用于新出现疾病和提高生存率的新治疗方法和程序。
