Brothers Lauren, Malhotra Jasmine, Andrews Cody, Smith Sean R
Strength and Relief Clinic, Farmington Hills, MI, USA.
Department of Physical Medicine and Rehabilitation, William Beaumont Hospital, Taylor, MI, USA.
Curr Oncol Rep. 2023 Mar;25(3):145-150. doi: 10.1007/s11912-023-01363-y. Epub 2023 Jan 21.
Despite advances in treatment, chronic graft-versus-host disease (cGVHD) remains a highly morbid complication of allogeneic hematopoietic stem cell transplantation. Due to direct effects of the disease on specific body sites, and its treatment, patients lose function. This review summarizes the latest evidence surrounding how cGVHD affects function, and restorative interventions.
Different body sites of cGVHD carry a higher risk of functional decline, including pulmonary and sclerotic/fascial. Support should be comprehensive and individualized, with precautions taken to avoid worsening fibrosis, offloading painful joints and fractures, and utilizing function-directed skilled therapies. Inpatient rehabilitation improves function in hospitalized people with cGVHD. For people with cGVHD, rehabilitation addresses different aspects of impaired function across the spectrum of disease. Given the dynamic nature of the disease process, routine assessment may be warranted. Rehabilitation may also improve deleterious effects of anti-cGVHD medication including glucocorticoids and tyrosine kinase inhibitors.
尽管在治疗方面取得了进展，但慢性移植物抗宿主病（cGVHD）仍然是异基因造血干细胞移植的一种高发病并发症。由于该疾病对特定身体部位及其治疗的直接影响，患者会出现功能丧失。本综述总结了有关cGVHD如何影响功能以及恢复性干预措施的最新证据。
cGVHD的不同身体部位功能下降风险更高，包括肺部和硬化/筋膜部位。支持措施应全面且个性化，要注意避免加重纤维化，减轻疼痛关节和骨折的负担，并采用功能导向的专业治疗方法。住院康复可改善cGVHD住院患者的功能。对于cGVHD患者，康复可解决疾病范围内功能受损的不同方面。鉴于疾病过程的动态性质，可能需要进行常规评估。康复还可能改善抗cGVHD药物（包括糖皮质激素和酪氨酸激酶抑制剂）的有害影响。
