University of Basel, Basel, Switzerland.
MEDISYN SA, Lucerne, Switzerland.
Bone Marrow Transplant. 2024 Oct;59(10):1349-1359. doi: 10.1038/s41409-024-02362-8. Epub 2024 Jul 14.
Hematopoietic stem cell transplantation (HCT) represents a curative treatment option for certain malignant and nonmalignant hematological diseases. Conditioning regimens before HCT, the development of graft-versus-host disease (GVHD) in the allogeneic setting, and delayed immune reconstitution contribute to early and late complications by inducing tissue damage or humoral alterations. Hemostasis and/or the complement system are biological regulatory defense systems involving humoral and cellular reactions and are variably involved in these complications after allogeneic HCT. The hemostasis and complement systems have multiple interactions, which have been described both under physiological and pathological conditions. They share common tissue targets, such as the endothelium, which suggests interactions in the pathogenesis of several serious complications in the early or late phase after HCT. Complications in which both systems interfere with each other and thus contribute to disease pathogenesis include transplant-associated thrombotic microangiopathy (HSCT-TMA), sinusoidal obstruction syndrome/veno-occlusive disease (SOS/VOD), and GVHD. Here, we review the current knowledge on changes in hemostasis and complement after allogeneic HCT and how these changes may define clinical impact.
造血干细胞移植（HCT）是某些恶性和非恶性血液病的一种有治愈可能的治疗选择。HCT 前的预处理方案、同种异体移植中的移植物抗宿主病（GVHD）的发展以及延迟的免疫重建通过诱导组织损伤或体液改变导致早期和晚期并发症。止血和/或补体系统是涉及体液和细胞反应的生物调节防御系统，在同种异体 HCT 后这些并发症中均有不同程度的参与。止血和补体系统之间存在多种相互作用，这些相互作用在生理和病理条件下均有描述。它们有共同的组织靶点，如内皮细胞，这表明在 HCT 后早期或晚期的几种严重并发症的发病机制中存在相互作用。相互干扰并因此有助于疾病发病机制的并发症包括移植相关性血栓性微血管病（HSCT-TMA）、窦状隙阻塞综合征/静脉阻塞性疾病（SOS/VOD）和 GVHD。在这里，我们综述了同种异体 HCT 后止血和补体变化的现有知识，以及这些变化如何定义临床影响。
