急性移植物抗宿主病。
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Jacobsohn哒,Vogelsang GB
急性移植物抗宿主病。
Orphanet J罕见说。2007年9月4,赛事。doi: 10.1186 / 1750-1172-2-35。
- PubMed ID
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17784964 (在PubMed]
- 文摘
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急性移植物抗宿主病(GVHD)同种异体造血干细胞移植后发生反应的捐赠者免疫细胞与宿主组织。激活供者T细胞损害宿主上皮细胞炎症级联后开始制备方案。约35% -50%的造血干细胞移植(HSCT)接受者将开发急性移植物抗宿主病。准确的风险是依赖于干细胞来源,病人的年龄,条件反射,GVHD预防使用。鉴于移植的数量表现,我们可以预期开发急性GVHD病人约5500 /年。病人可以有参与的三个器官:皮肤(皮疹/皮炎),肝脏(肝炎/黄疸),胃肠道(腹痛、腹泻)。一个或多个器官可能涉及。移植物抗宿主病是临床诊断,可以支持适当的活检。追求组织活检的理由是帮助区分从其他诊断可能模仿移植物抗宿主病,如病毒感染(肝炎、结肠炎)或药物反应(导致皮疹)。急性移植物抗宿主病是上演和分级(0-IV)级机关参与的数量和程度。 Patients with grade III/IV acute GVHD tend to have a poor outcome. Generally the patient is treated by optimizing their immunosuppression and adding methylprednisolone. About 50% of patients will have a solid response to methylprednisolone. If patients progress after 3 days or are not improved after 7 days, they will get salvage (second-line) immunosuppressive therapy for which there is currently no standard-of-care. Well-organized clinical trials are imperative to better define second-line therapies for this disease. Additional management issues are attention to wound infections in skin GVHD and fluid/nutrition management in gastrointestinal GVHD. About 50% of patients with acute GVHD will eventually have manifestations of chronic GVHD.
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- 药物