Bronchiolitis obliterans syndrome after allogeneic hematopoietic stem cell transplantation-an increasingly recognized manifestation of chronic graft-versus-host disease.
Bronchiolitis obliterans syndrome after allogeneic hematopoietic stem cell transplantation-an increasingly recognized manifestation of chronic graft-versus-host disease.
复制标题
DOI：
10.1016/j.bbmt.2009.11.002
复制
发表时间：
2010-01
影响因子：
4.3
通讯作者：
Pavletic, Steven Z.
中科院分区：
文献类型：
--
作者：
Chien, Jason W.;Duncan, Steven;Williams, Kirsten M.;Pavletic, Steven Z.
闭塞性细支气管炎综合征（BOS）是一种进行性、隐匿性且通常致命的肺同种异体反应，可在异基因造血干细胞移植（HCT）或异基因肺移植后发生。目前文献中的估计表明，大约2-3%的同种异体HCT接受者和6%的慢性GVHD患者会出现这种综合征。然而，根据最新的数据，BOS的真实发生率可能更高。不幸的是，在过去的20年里，HCT后BOS患者的生存和治疗没有改善。由于缺乏统一的诊断标准和无法在其自然史的可逆阶段检测该综合征，临床试验的尝试受到阻碍。最近，NIH慢性GVHD标准共识项目提出了关于BOS诊断和长期存活者肺部疾病监测的建议。尽管BOS是一种罕见且知之甚少的慢性GVHD表现，但它通常发生在肺移植后，并且在病理学、临床表现、影像学表现和假定的免疫学发病机制方面相似。本文综述了目前对BOS的流行病学和发病机制的认识，并介绍了HCT后BOS患者的评估和治疗信息。
Bronchiolitis obliterans syndrome (BOS) is a progressive, insidious, and often fatal lung allo-reaction that can occur following allogeneic hematopoietic stem cell transplantation (HCT) or allogeneic lung transplantation. Current estimates in the literature suggest that approximately 2–3% of all allogeneic HCT recipients and 6% of patients who develop chronic GVHD will develop this syndrome. However, based on newer data it is likely that the true incidence of BOS is higher. Unfortunately, the survival and treatment of patients with BOS after HCT has not improved over the last 20 years. Attempts at clinical trials have been hindered by the lack of uniform diagnostic criteria and inability to detect the syndrome at a reversible stage in its natural history. Recently, the NIH consensus project for criteria in chronic GVHD has made recommendations regarding the diagnosis of BOS and monitoring of lung disease among long term survivors. Although a rare and poorly understood manifestation of chronic GVHD, BOS occurs commonly after lung transplantation and is similar in pathology, clinical presentation, radiographic presentation, and presumed immunologic pathogenesis. This review describes the current understanding of the epidemiology and pathogenesis of BOS and presents information on evaluations and therapies for patients with BOS after HCT.
登录
查看更多内容
影响因子：
20.3
作者：
Chien, JW;Zhao, LP;Clark, JG
通讯作者：
Clark, JG
影响因子：
15.9
作者：
Duncan, SR;Capetanakis, NG;Theofilopoulos, AN
通讯作者：
Theofilopoulos, AN
DOI：
10.1164/rccm.200201-003pp
发表时间：
2002-08-15
影响因子：
24.7
作者：
Estenne, M;Hertz, MI
通讯作者：
Hertz, MI
影响因子：
39.2
作者：
CLARK, JG;CRAWFORD, SW;SULLIVAN, KM
通讯作者：
SULLIVAN, KM
影响因子：
39.2
作者：
CLARK, JG;SCHWARTZ, DA;THOMAS, ED
通讯作者：
THOMAS, ED