Department, of Clinical Haematology, Peter MacCallum Cancer Centre and The Royal Melbourne Hospital, Parkville, VIC, Australia.
ACRF Translational Research Laboratory, Royal Melbourne Hospital, Parkville, VIC, Australia.
Bone Marrow Transplant. 2022 Oct;57(10):1489-1499. doi: 10.1038/s41409-022-01761-z. Epub 2022 Jul 23.
The development of non-relapse cytopenias (NRC) is a relatively common occurrence post allogeneic stem cell transplant (alloSCT). Whilst there have been attempts to classify post alloSCT cytopenias by transplantation groups, ambiguity of definitions in prior publications compounded by a lack of availability of high-quality evidence, provide challenges to clinicians attempting to manage these complex patients. In this review we describe 3 cases of NRC, (1) Graft Failure with graft rejection representing cytopenias with minimal donor chimerism (2) Poor Graft Function representing cytopenias with complete donor chimerism and (3) Cytopenias with mixed donor chimerism. This case-based review will evaluate the currently available evidence regarding the pathophysiology of each entity as well as the evidence for current therapies with the aim of providing guidance to clinicians managing these complex patients.
非复发性血细胞减少症（NRC）是异基因干细胞移植（alloSCT）后相对常见的一种情况。虽然已经有尝试根据移植类型对alloSCT 后血细胞减少症进行分类，但由于先前出版物中的定义不明确，再加上缺乏高质量证据，这给试图治疗这些复杂患者的临床医生带来了挑战。在本综述中，我们描述了 3 例 NRC，（1）移植物衰竭伴移植物排斥，表现为供者嵌合率极低的血细胞减少症；（2）移植物功能不良，表现为完全供者嵌合的血细胞减少症；（3）混合供者嵌合性血细胞减少症。本基于病例的综述将评估关于每种实体的病理生理学的现有证据，以及目前治疗方法的证据，旨在为管理这些复杂患者的临床医生提供指导。
