How I treat acute graft-versus-host disease of the gastrointestinal tract and the liver

被引：51

作者：

McDonald, George B. ^{[1
,2
]}

机构：

[1] Fred Hutchinson Canc Res Ctr, Div Clin Res, Gastroenterol Hepatol Sect, Seattle, WA 98109 USA

[2] Univ Washington, Sch Med, Seattle, WA 98195 USA

来源：

BLOOD | 2016年 / 127卷 / 12期

关键词：

HEMATOPOIETIC-CELL TRANSPLANTATION; ORAL BECLOMETHASONE DIPROPIONATE; ACUTE GVHD; MARROW TRANSPLANTATION; NONRELAPSE MORTALITY; HEPATIC COMPLICATIONS; PREDICTS RESPONSE; CONTROLLED-TRIAL; SURVIVAL; THERAPY;

D O I：

10.1182/blood-2015-10-612747

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

Treatment of acute graft-versus-host disease (GVHD) has evolved from a one-size-fits-all approach to a more nuanced strategy based on predicted outcomes. Lower and time-limited doses of immune suppression for patients predicted to have low-risk GVHD are safe and effective. In more severe GVHD, prolonged exposure to immunosuppressive therapies, failure to achieve tolerance, and inadequate clinical responses are the proximate causes of GVHD-related deaths. This article presents acute GVHD-related scenarios representing, respectively, certainty of diagnosis, multiple causes of symptoms, jaundice, an initial therapyalgorithm, secondary therapy, and defining futility of treatment.

引用

页码：1544 / 1550

页数：7

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