Steroid myopathy in patients with acute graft-versus-host disease treated with high-dose steroid therapy
Steroid myopathy in patients with acute graft-versus-host disease treated with high-dose steroid therapy
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DOI：
10.1038/sj.bmt.1705435
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发表时间：
2006-08-01
影响因子：
4.8
通讯作者：
Giralt, S.
中科院分区：
文献类型：
--
作者：
Lee, H. J.;Oran, B.;Giralt, S.
高剂量类固醇是治疗急性移植物抗宿主病（aGVHD）的第一线。类固醇肌病是一种使人衰弱的类固醇引起的并发症，显著损害患者的体力状态。为了确定异基因造血干细胞移植（HSCT）后发生≥ 2级aGVHD的急性髓性白血病（AML）/骨髓增生异常综合征（MDS）患者类固醇肌病和其他类固醇相关并发症的频率和严重程度，我们进行了一项回顾性分析。如果患者被诊断为AML/MDS，在1996年1月至2001年12月期间接受了同种异体HSCT，并发生了>= 2级aGVHD，用2 mg/kg甲泼尼龙治疗，并在移植后存活至少100天，则将其纳入分析。共有70名患者符合我们的入选标准。29例（41%）患者发现类固醇肌病。类固醇肌病的严重程度一般为中度，仅3%的患者出现重度衰弱性类固醇肌病。我们的结论是类固醇肌病是AML/MDS患者异基因HSCT后大剂量类固醇治疗的常见并发症。旨在预防和治疗这种并发症的干预措施是必要的，需要在前瞻性临床试验中进行探索。
High-dose steroids are the first line of treatment for acute graft-versus-host disease (aGVHD). Steroid myopathy is a debilitating steroid-induced complication that significantly impairs a patient's performance status. To determine the frequency and severity of steroid myopathy and other steroid related complications in patients with acute myeloid leukemia (AML)/myelodysplastic syndrome (MDS) who developed grade >= 2 aGVHD after allogeneic hematopoietic stem cell transplantation (HSCT), we performed a retrospective analysis. Patients were included in the analysis if they had a diagnosis of AML/MDS, underwent an allogeneic HSCT between January 1996 and December 2001 and developed grade >= 2 aGVHD that was treated with 2 mg/kg of methylprednisolone and survived at least 100 days post transplant. A total of 70 patients fulfilled our inclusion criteria. Steroid myopathy was identified in 29 (41%) patients. Steroid myopathy was generally of moderate severity with severe debilitating steroid myopathy seen in only 3% of patients. We concluded that steroid myopathy is a common complication of high-dose steroid therapy after allogeneic HSCT in AML/MDS. Interventions aimed at preventing and treating this complication are warranted and need to be explored in prospective clinical trials.