Toward a Better Understanding of the Atypical Features of Chronic Graft-Versus-Host Disease: A Report from the 2020 National Institutes of Health Consensus Project Task Force.
Toward a Better Understanding of the Atypical Features of Chronic Graft-Versus-Host Disease: A Report from the 2020 National Institutes of Health Consensus Project Task Force.
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更好地了解慢性移植物抗宿主病的非典型特征：2020 年美国国立卫生研究院共识项目工作组的报告。
DOI：
10.1016/j.jtct.2022.05.038
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发表时间：
2022-08
影响因子：
3.2
通讯作者：
Wolff, Daniel
中科院分区：
文献类型：
--
作者：
Cuvelier, Geoffrey D. E.;Schoettler, Michelle;Buxbaum, Nataliya P.;Pinal-Fernandez, Iago;Schmalzing, Marc;Distler, Joerg H. W.;Penack, Olaf;Santomasso, Bianca D.;Zeiser, Robert;Angstwurm, Klemens;MacDonald, Kelli P. A.;Kimberly, W. Taylor;Taylor, Naomi;Bilic, Ervina;Banas, Bernhard;Buettner-Herold, Maike;Sinha, Namita;Greinix, Hildegard T.;Pidala, Joseph;Schultz, Kirk R.;Williams, Kirsten M.;Inamoto, Yoshihiro;Cutler, Corey;Griffith, Linda M.;Lee, Stephanie J.;Sarantopoulos, Stefanie;Pavletic, Steven Z.;Wolff, Daniel
关键词：
异基因造血细胞移植后的同种异体反应性和自身免疫反应可发生在非经典慢性移植物抗宿主病（慢性GVHD）组织和器官系统中，或以非典型方式表现在通常受慢性GVHD影响的经典器官中。美国国立卫生研究院（NIH）的共识项目的开发，以提高慢性GVHD的临床特征和诊断标准的理解和分类。虽然仍在推测非典型表现是否完全是由于慢性GVHD，但这些表现仍然没有被当前NIH共识项目标准所捕获。实例包括影响造血系统的慢性GVHD，如免疫介导的血细胞减少、内皮功能障碍或肌肉骨骼系统、中枢和外周神经系统、肾脏和浆膜中的非典型特征。这些所谓的慢性GVHD特征可能会导致患者的发病率和死亡率显着。大多数非典型慢性GVHD特征很少得到研究，特别是在多机构和前瞻性研究中，限制了我们对其频率，发病机制以及与慢性GVHD关系的理解。这份NIH共识项目工作组报告提供了关于慢性GVHD非典型表现的已知和未知的最新信息，同时概述了未来三到七年内进行的研究框架。我们还为每种非典型表现提供了临时诊断标准，沿着临床医生管理具有非典型慢性GVHD特征的患者的实用调查策略。
Alloreactive and autoimmune responses after allogeneic hematopoietic cell transplantation can occur in non-classical chronic graft-versus-host disease (chronic GVHD) tissues and organ systems or manifest in atypical ways in classical organs commonly affected by chronic GVHD. The National Institutes of Health (NIH) consensus projects were developed to improve understanding and classification of the clinical features and diagnostic criteria for chronic GVHD. While still speculative whether atypical manifestations are entirely due to chronic GVHD, these manifestations remain poorly captured by the current NIH consensus project criteria. Examples include chronic GVHD impacting the hematopoietic system as immune mediated cytopenias, endothelial dysfunction, or as atypical features in the musculoskeletal system, central and peripheral nervous system, kidneys, and serous membranes. These purported chronic GVHD features may contribute significantly to patient morbidity and mortality. Most of the atypical chronic GVHD features have received little study, particularly within multi-institutional and prospective studies, limiting our understanding of their frequency, pathogenesis, and relation to chronic GVHD. This NIH consensus project task force report provides an update on what is known and not known about the atypical manifestations of chronic GVHD, while outlining a research framework for future studies to be undertaken within the next three to seven years. We also provide provisional diagnostic criteria for each atypical manifestation, along with practical investigation strategies for clinicians managing patients with atypical chronic GVHD features.
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影响因子：
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