慢性移植物抗宿主病的防治新进展  

Advances in prevention and treatment of chronic graft versus host disease

作　　者：张晓 朱晗[1] 李建勇[1] 缪扣荣[1] Zhang Xiao;Zhu Han;Li Jianyong;Miao Kourong(Department of Hematology,First Affiliated Hospital of Nanjing Medical University,Jiangsu Province Hospital,Nanjing 210029,Jiangsu Province,China)

机构地区：[1]南京医科大学第一附属医院血液科(江苏省人民医院),210029

出　　处：《国际输血及血液学杂志》2020年第5期391-397,共7页International Journal of Blood Transfusion and Hematology

基　　金：国家自然科学基金项目(81470329、81500125)。

摘　　要：慢性移植物抗宿主病(cGVHD)是异基因造血干细胞移植(allo-HSCT)后常见并发症。allo-HSCT前,对患者采取的移植物抗宿主病(GVHD)标准预防方案,可明显降低其急性GVHD(aGVHD)发生率,但是对降低cGVHD发生率效果不明显。现阶段以抗胸腺细胞球蛋白(ATG)为代表的GVHD预防方案,可以显著降低患者的cGVHD发生率及疾病严重程度。糖皮质激素是cGVHD的一线治疗药物,对于激素难治性cGVHH(SR-cGVHD)患者,目前已有多种新型二线药物,但尚无首选治疗方案。靶向cGVHD生物标志物的相关研究,将为其治疗提供新的方向。笔者拟就cGVHD的预防、治疗及生物标志物相关研究的新进展进行阐述。Chronic graft versus host disease(cGVHD)is a common complication after allogeneic hematopoietic stem cell transplantation(allo-HSCT).Usage of prophylactic strategies of graft versus host disease(GVHD)before allo-HSCT significantly reduces the incidence of acute GVHD(aGVHD),but it plays a small role in reducing the incidence of cGVHD.At this stage,prophylactic drugs represented by antithymocyte globulin(ATG)can significantly reduce the incidence and severity of cGVHD.Corticosteroids are the first-line treatment of cGVHD.There are many new second-line drug choices for steroid-refractory cGVHD(SR-cGVHD)patients,but there is no first choice for it.The studies of targeted biomarkers of cGVHD will provide a new direction for the treatment of cGVHD in the future.This article summerizes the advances in the prevention,treatment and biomarkers of cGVHD.

关 键 词：造血干细胞移植 移植物抗宿主病 慢性病 预防和防护用药 药物疗法 生物学标记 

分 类 号：R457.7[医药卫生—治疗学]