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Spätfolgen der allogenen Blutstammzelltransplantation

Delayed sequelae of allogeneic hematopoietic stem cell transplantation

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Zusammenfassung

In jedem Jahr erhalten in Deutschland ca. 3000 Patienten eine allogene Blutstammzelltransplantation (SZT). Die Überlebensraten dieser Patienten haben sich durch die Fortschritte in der Transplantationsmedizin und Supportivtherapie in den letzten Jahren erheblich verbessert. Dennoch ist die Lebenserwartung der transplantierten Patienten im Vergleich zur Gesamtbevölkerung verkürzt. Ursächlich dafür ist das gesteigerte Risiko für das Auftreten von Folgeerkrankungen bei Langzeitüberlebenden, die auch nach einem symptomfreien Intervall Jahre nach der SZT auftreten können. Das Spektrum der Folgeerkrankungen reicht von kardiovaskulären Spätschäden und diversen Organdysfunktionen bis hin zu Sekundärmalignomen. Dieser Beitrag gibt eine Übersicht über die häufigsten Spätfolgen nach SZT und Empfehlungen zur Langzeitnachsorge der Patienten. Um Langzeitfolgen zu verhindern bzw. rechtzeitig zu erkennen und zu behandeln, ist eine multidisziplinäre Nachsorge der Patienten erforderlich.

Abstract

Annually approximately 3000 patients receive an allogeneic hematopoietic stem cell transplantation (SCT) in Germany. Recently, survival rates were remarkably improved due to the progress in transplantation medicine as well as supportive care; however, the life expectancy of patients is shorter compared with the general population. This is caused by the increased risk of delayed sequelae in long-term survivors, which can occur years after an asymptomatic interval following SCT. The spectrum of delayed sequelae includes late cardiovascular effects and diverse organ dysfunctions as well as secondary malignancies. This article provides an overview and recommendations for screening and preventive measures regarding frequently occurring late effects after SCT. Besides preventive measures a multidisciplinary follow-up of patients is required for early detection and treatment of late effects.

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Literatur

  1. Gooley TA, Chien JW, Pergam SA et al (2010) Reduced mortality after allogeneic hematopoietic-cell transplantation. N Engl J Med 363(22):2091–2101

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  2. Wingard JR, Majhail NS, Brazauskas R et al (2011) Long-term survival and late deaths after allogeneic hematopoietic cell transplantation. J Clin Oncol 29(16):2230–2239

    Article  PubMed Central  PubMed  Google Scholar 

  3. Sun C, Francisco L, Kawashima T et al (2010) Prevalence and predictors of chronic health conditions after hematopoietic cell transplantation: a report from the Bone Marrow Transplant Survivor Study. Blood 116(17):3129–3139

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  4. Majhail NS, Rizzo JD, Lee SJ et al (2012) Recommended screening and preventive practices for long-term survivors after hematopoietic cell transplantation. Biol Blood Marrow Transplant 18(3):348–371

    Article  PubMed Central  PubMed  Google Scholar 

  5. Rizzo JD, Wingard JR, Tichelli A et al (2006) Recommended screening and preventive practices for long-term survivors after hematopoietic cell transplantation: joint recommendations of the European Group for Blood and Marrow Transplantation, the Center for International Blood and Marrow Transplant Research, and the American Society of Blood and Marrow Transplantation. Biol Blood Marrow Transplant 12(2):138–151

    Article  PubMed  Google Scholar 

  6. Hilgendorf I, Greinix H, Halter JP et al (2015) Langzeitnachsorge nach allogener Stammzelltransplantation. Dtsch Arztbl Int 112(4):51–58

    Google Scholar 

  7. Wolff D, Bertz H, Greinix H et al (2011) The treatment of chronic graft-versus-host disease: consensus recommendations of experts from Germany, Austria, and Switzerland. Dtsch Arztbl Int 108(43):732–740

    Google Scholar 

  8. Kauppila M, Koskinen P, Irjala K et al (1998) Long-term effects of allogeneic bone marrow transplantation (BMT) on pituitary, gonad, thyroid and adrenal function in adults. Bone Marrow Transplant 22(4):331–337

    Article  CAS  PubMed  Google Scholar 

  9. Tichelli A, Bucher C, Rovó A et al. (2007) Premature cardiovascular disease after allogeneic hematopoietic stem-cell transplantation. Blood 110(9):3463–3471

    Article  CAS  PubMed  Google Scholar 

  10. Hilgendorf I, Freund M, Jilg W et al (2011) Vaccination of allogeneic haematopoietic stem cell transplant recipients: report from the international consensus conference on clinical practice in chronic GVHD. Vaccine 29(16):2825–2833

    Article  PubMed  Google Scholar 

  11. Kida A, McDonald GB (2012) Gastrointestinal, hepatobiliary, pancreatic, and iron-related diseases in long-term survivors of allogeneic hematopoietic cell transplantation. Semin Hematol 49(1):43–58

    Article  PubMed  Google Scholar 

  12. Majhail NS, Lazarus HM, Burns LJ (2010) A prospective study of iron overload management in allogeneic hematopoietic cell transplantation survivors. Biol Blood Marrow Transplant 16(6):832–837

    Article  CAS  PubMed  Google Scholar 

  13. Tran J, Norder EE, Diaz PT et al (2012) Pulmonary rehabilitation for bronchiolitis obliterans syndrome after hematopoietic stem cell transplantation. Biol Blood Marrow Transplant 18(8):1250–1254

    Article  PubMed Central  PubMed  Google Scholar 

  14. McClune BL, Polgreen LE, Burmeister LA et al (2011) Screening, prevention and management of osteoporosis and bone loss in adult and pediatric hematopoietic cell transplant recipients. Bone Marrow Transplant 46(1):1–9

    Article  CAS  PubMed  Google Scholar 

  15. Solaro C, Murialdo A, Giunti D et al (2001) Central and peripheral nervous system complications following allogeneic bone marrow transplantation. Eur J Neurol 8(1):77–80

    Article  CAS  PubMed  Google Scholar 

  16. Gallardo D, Ferra C, Berlanga JJ et al (1996) Neurologic complications after allogeneic bone marrow transplantation. Bone Marrow Transplant 18(6):1135–1139

    CAS  PubMed  Google Scholar 

  17. Teive HAG, Funke V, Bitencourt MA et al (2008) Neurological complications of hematopoietic stem cell transplantation (HSCT): a retrospective study in a HSCT center in Brazil. Arq Neuropsiquiatr 66(3B):685–690

    Article  PubMed  Google Scholar 

  18. Brabander C de, Cornelissen J, Smitt PA et al (2000) Increased incidence of neurological complications in patients receiving an allogenic bone marrow transplantation from alternative donors. J Neurol Neurosurg Psychiatry 68(1):36–40

    Article  PubMed Central  PubMed  Google Scholar 

  19. Sostak P, Padovan CS, Yousry TA et al (2003) Prospective evaluation of neurological complications after allogeneic bone marrow transplantation. Neurology 60(5):842–848

    Article  CAS  PubMed  Google Scholar 

  20. Abboud I, Peraldi M, Hingorani S (2012) Chronic kidney diseases in long-term survivors after allogeneic hematopoietic stem cell transplantation: monitoring and management guidelines. Semin Hematol 49(1):73–82

    Article  PubMed  Google Scholar 

  21. Rizzo JD, Curtis RE, Socié G et al (2009) Solid cancers after allogeneic hematopoietic cell transplantation. Blood 113(5):1175–1183

    Article  PubMed Central  CAS  PubMed  Google Scholar 

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Einhaltung ethischer Richtlinien

Interessenkonflikt. I. Hilgendorf und A. Hochhaus geben an, dass kein Interessenkonflikt besteht. Dieser Beitrag beinhaltet keine Studien an Menschen oder Tieren.

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  1. Klinik für Innere Medizin II, Abteilung für Hämatologie und Internistische Onkologie, Universitäsklinikum Jena, Erlanger Allee 101, 07747, Jena, Deutschland

    I. Hilgendorf & A. Hochhaus

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  1. I. Hilgendorf
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  2. A. Hochhaus
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Correspondence to I. Hilgendorf.

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Hilgendorf, I., Hochhaus, A. Spätfolgen der allogenen Blutstammzelltransplantation. Onkologe 21, 433–442 (2015). https://doi.org/10.1007/s00761-015-2923-3

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  • DOI: https://doi.org/10.1007/s00761-015-2923-3

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