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造血干细胞移植后内皮功能紊乱的诊断与治疗。

Diagnosis and management of endothelial disorders following haematopoietic stem cell transplantation.

机构信息

Haematology Department, Royal North Shore Hospital, Sydney, New South Wales, Australia.

Haematology Department, Liverpool Hospital, Sydney, New South Wales, Australia.

出版信息

Intern Med J. 2023 Dec;53(12):2162-2174. doi: 10.1111/imj.16188. Epub 2023 Aug 1.

Abstract

Haematopoietic stem cell transplantation is a mainstay of therapy for numerous malignant and nonmalignant diseases. Endothelial activation and dysfunction occur after stem cell transplantation, driven by various patient- and transplant-specific factors. This can manifest as one of the relatively uncommon endothelial injury syndromes, such as sinusoidal obstruction syndrome, transplant-associated thrombotic microangiopathy, idiopathic pneumonia syndrome, capillary leak syndrome, engraftment syndrome or posterior reversible encephalopathy syndrome. This review focuses on the pathogenesis, classification and diagnosis of these disorders, as well as provides guidance on risk mitigation and treatment.

摘要

造血干细胞移植是治疗许多恶性和非恶性疾病的主要方法。干细胞移植后,由于各种患者和移植特异性因素,会发生内皮细胞激活和功能障碍。这可能表现为相对罕见的内皮损伤综合征之一,如窦阻塞综合征、移植相关血栓性微血管病、特发性肺炎综合征、毛细血管渗漏综合征、植入综合征或可逆性后部脑病综合征。本综述重点介绍这些疾病的发病机制、分类和诊断,并提供了关于风险缓解和治疗的指导。

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