异基因干细胞移植前后肺功能检测的意义

Takahiko Nakane, Mariko Yamashita
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引用次数: 0

摘要

同种异体造血干细胞移植(Allogeneic hematopoietic stem cell transplantation, allo-HCT)是治疗多种血液病的一种有效方法,但移植相关死亡率(TRM)仍然存在问题,几乎占接受同种异体造血干细胞移植的患者的四分之一。TRM主要由感染(细菌、病毒和细菌)、急性或慢性移植物抗宿主病(GVHD)和/或器官功能障碍引起,如涉及肝、肺和/或肾。移植后感染性或非感染性肺部并发症是同种异体hct术后常与TRM相关的一些重要事件。移植前或移植后肺功能测试(PFT)在以下方面发挥重要作用:1)它可以预测非感染性肺部并发症的发展,如肺慢性GVHD,即闭塞性细支气管炎综合征(BOS)。2) BOS的诊断标准和严重程度评价包含了一些PFT参数。因此,我们无法诊断BOS患者,也无法评估没有PFT的患者的严重程度。3)移植前和移植后的pft预测TRM和/或整体移植结果。为了提高同种异体hct的预后,需要进一步研究同种异体hct中的PFT。(审查)。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
[The Significance of Pulmonary Function Testing Before and After Allogeneic Stem Cell Transplantation].

Allogeneic hematopoietic stem cell transplantation (allo-HCT) is a curative treatment for many kinds of hematological diseases, but high transplant-related mortality (TRM), involving almost one quarter of patients who receive allo-HCT, remains problematic. TRM is mainly caused by infection (bacteria, virus, and fun- gus), acute or chronic graft versus host disease (GVHD), and/or organ dysfunction, such as-that involving the liver, lung, and/or kidney. Post-transplant infectious or noninfectious pulmonary complications are some of the important events after allo-HCT that may often be associated with TRM. The pre- or post-transplant pulmonary function test (PFT) plays an important role for the following reasons: 1) It may predict the devel- opment of noninfectious pulmonary complications such as chronic GVHD of the lung, i.e., bronchiolitis oblit- erans syndrome (BOS). 2) The diagnostic criteria and evaluation of the severity of BOS contain some PFT parameters. Therefore, we are not able to diagnose a patient with BOS nor evaluate the severity without PFT. 3) Pre- and post-transplant PFTs predict TRM and/or the overall transplant outcome. In order to improve the allo-HCT outcome, future studies of PFT in allo-HCT are needed. [Review].

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