TAILIEUCHUNG - Chapter 108. Hematopoietic Cell Transplantation (Part 5)

Graft-versus-Host Disease GVHD is the result of allogeneic T cells that were either transferred with the donor's stem cell inoculum or develop from it, reacting with antigenic targets on host cells. GVHD developing within the first 3 months posttransplant is termed acute GVHD, while GVHD developing or persisting beyond 3 months posttransplant is termed chronic GVHD. Acute GVHD most often first becomes apparent 2–4 weeks posttransplant and is characterized by an erythematous maculopapular rash; persistent anorexia or diarrhea, or both; and by liver disease with increased serum levels of bilirubin, alanine and aspartate aminotransferase, and alkaline phosphatase. . | Chapter 108. Hematopoietic Cell Transplantation Part 5 Graft-versus-Host Disease GVHD is the result of allogeneic T cells that were either transferred with the donor s stem cell inoculum or develop from it reacting with antigenic targets on host cells. GVHD developing within the first 3 months posttransplant is termed acute GVHD while GVHD developing or persisting beyond 3 months posttransplant is termed chronic GVHD. Acute GVHD most often first becomes apparent 2-4 weeks posttransplant and is characterized by an erythematous maculopapular rash persistent anorexia or diarrhea or both and by liver disease with increased serum levels of bilirubin alanine and aspartate aminotransferase and alkaline phosphatase. Since many conditions can mimic acute GVHD diagnosis usually requires skin liver or endoscopic biopsy for confirmation. In all these organs endothelial damage and lymphocytic infiltrates are seen. In skin the epidermis and hair follicles are damaged in liver the small bile ducts show segmental disruption and in intestines destruction of the crypts and mucosal ulceration may be noted. A commonly used rating system for acute GVHD is shown in Table 108-1. Grade I acute GVHD is of little clinical significance does not affect the likelihood of survival and does not require treatment. In contrast grades II to IV GVHD are associated with significant symptoms and a poorer probability of survival and they require aggressive therapy. The incidence of acute GVHD is higher in recipients of stem cells from mismatched or unrelated donors in older patients and in patients unable to receive full doses of drugs used to prevent the disease. Table 108-1 Clinical Staging and Grading of Acute Graft-versus-Host Disease Clinical Skin Liver Gut Stage Bilirubin pmol L mg dL 1 Rash 25 34-51 2-3 Diarrhea body surface 500-1000 mL d 2 3 4 Overall Clinical Grade I II III IV Rash 25-50 51-103 3-6 Diarrhea body surface 1000-1500 mL d Generalized erythroderma 15 103-257 6- Diarrhea 1500 mL d .

• Y học thường thức
• Hematopoietic Cell Transplantation
• bệnh học và điều trị
• bài giảng bệnh học
• tài liệu học ngành y
• Harrisons Internal Medicine
• BMC Cancer
• Cumulative incidence rates
• Transplantation related mortality
• Risk factor
• Hematopoietic stem cell transplantation
• Acute leukemia
• Intestinal mucositis
• Diamine oxidase
• Circulating citrulline
• Pre HSCT factors
• Graft versus host disease
• Post traumatic stress disorder
• Hospital Anxiety and Depression Scale
• Acute lymphoblastic leukemia
• Tyrosine kinase inhibitor
• Chronic myeloid leukemia
• Kinase inhibitors
• B thalassemia major
• Fanconi’s anemia
• Immunodeficiency diseases
• Inherited metabolic disorders
• BMC Pediatrics
• Inhibin B
• Anti Müllerian hormone
• Luteinizing hormone
• Pediatric intensive care unit
• Possible predictive factors
• Pediatric critical illness score
• Peptides regulating gastrointestinal tract functions
• Gastrointestinal tract complications
• Acute graft versus
• Donor leukemia
• Whole exome sequencing
• Skin cancer
• Skin self examination
• Early detection
• Patient activation
• Veno occlusive disease
• Cytokine serum
• Interleukin 8
• Acute myeloid leukemia
• Allogeneic hematopoietic stem cell transplantation
• Wilms’ tumor gene 1
• Prognostic role
• BMC Pulmonary Medicine
• Late onset noninfectious pulmonary complications
• Pleuroparenchymal fibroelastosis
• Idiopathic pneumonia syndrome
• Childhood acute myeloid leukemia
• Allogeneic hematopoietic stem cell transplantation
• Pediatric acute myeloid leukemia
• Overall survival
• Area under the concentration time curve
• Meta analysis
• ß blocker
• Repurposed drugs
• Multiple myeloma