References

nodgo

Российский журнал детской гематологии и онкологии (РЖДГиО)

Russian Journal of Pediatric Hematology and Oncology

2311-12672413-5496

LTD “Graphica”

10.17650/2311-1267-2017-4-2-29-39

nodgo-293

Research Article

Обзоры литературы

Поздние осложнения у детей, перенесших трансплантацию гемопоэтических стволовых клеток (обзор литературы)

Late effects in children who underwent hematopoietic stem cell transplantation (review)

Киргизов

К. И.

Kirgizov

K. I.

117997, Москва, ул. Саморы Машела, 1

1 Samory Mashela St., Moscow, 117997

kirill.kirgizov@fccho-moscow.ru

ФГБУ «Национальный научно-практический центр детской гематологии, онкологии и иммунологии им. Дмитрия Рогачева» Минздрава РоссииРоссияDmitry Rogachev National Research Center of Pediatric Hematology, Oncology and Immunology Ministry of Health of RussiaRussian Federation

2017

16062017

422939

2017

Киргизов К.И.

Kirgizov K.I.

Данная работа распространяется под лицензией Creative Commons Attribution 4.0.

This work is licensed under a Creative Commons Attribution 4.0 License.

https://journal.nodgo.org/jour/article/view/293

Оценка поздних осложнений у детей, перенесших трансплантацию гемопоэтических стволовых клеток (ТГСК), разработка их комплексной реабилитации и профилактики являются актуальной задачей детской гематологии-онкологии. Ятрогенные расстройства, связанные с трансплантацией, затрагивают большинство органов и систем организма и ухудшают качество жизни ребенка. В обзоре литературы представлены наиболее часто возникающие поздние эффекты, фиксируемые у детей после ТГСК, которые сгруппированы в соответствии с их влиянием на органы и системы ребенка. Показано, что наибольшее внимание должно уделяться иммуноопосредованным поздним эффектам, вопросам иммунореконституции и поражениям сердечно-сосудистой, дыхательной и костно-мышечной систем, вторичному метаболическому синдрому. Отмечено, что в связи с новыми подходами к ТГСК (тотальное облучение тела, лимфодеплеция, посттрансплантационная клеточная терапия и др.) особое внимание требуется уделять вопросам воздействия на иммунную систему ребенка. Важными проблемами являются развитие нейрокогнитивного и психологического дефицитов. Посттрансплантационное ведение пациентов должно включать медицинскую, нейрокогнитивную, академическую, психологическую и социальную помощь по преодолению последствий трансплантации, что диктует необходимость создания национальных клинических рекомендаций по поздним осложнениям ТГСК, которые будут являться основой для совместной работы трансплантационных и реабилитационных центров.

Estimation of late effects at children underwent hematopoietic stem cell transplantation (HSCT), development of complex rehabilitation and prophylaxis measures is the actual task of pediatric hematology-oncology. Iatrogenic pathology associated with transplantation affects majority of organs and systems and decreasing of quality of life of child. Most frequently occurring late effects revealed in children after HSCT, grouped by the influence on organs and systems of child, are showed in this review. It was shown that the biggest attention must be paid to immune mediated late effects, questions of immune reconstitution and damage of cardio-vascular, respiratory and musculoskeletal systems, secondary metabolic syndrome. It was marked that due to new approaches to HSCT (total body irradiation, lymphodepletion, post-transplant cell therapy, etc.) special attention must be paid to questions of affecting of immune system of child. Important problem is the development of neurocognitive and psychological deficits. Post-transplant observation of patients must include medical, neurocognitive, academic, psychological and social help to overcoming obstacles of transplantation. Thus, preparation of national clinical recommendations for late effects and HSCT must be done. These recommendations will be the base for collaborative work of transplant and rehabilitation centers.

детитрансплантация гемопоэтических стволовых клетокпоздние эффектынаблюдение

childrenhematopoietic stem cell transplantationlate complicationsobservation

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The authors declare that there are no conflicts of interest present.