Поздние осложнения у детей, перенесших трансплантацию гемопоэтических стволовых клеток (обзор литературы)
Аннотация
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.
Об авторе
К. И. Киргизов
ФГБУ «Национальный научно-практический центр детской гематологии, онкологии и иммунологии им. Дмитрия Рогачева» Минздрава России
Россия
117997, Москва, ул. Саморы Машела, 1
Россия
117997, Москва, ул. Саморы Машела, 1
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Рецензия
Для цитирования:
Киргизов К.И. Поздние осложнения у детей, перенесших трансплантацию гемопоэтических стволовых клеток (обзор литературы). Российский журнал детской гематологии и онкологии (РЖДГиО). 2017;4(2):29-39. https://doi.org/10.17650/2311-1267-2017-4-2-29-39
For citation:
Kirgizov K.I. Late effects in children who underwent hematopoietic stem cell transplantation (review). Russian Journal of Pediatric Hematology and Oncology. 2017;4(2):29-39. (In Russ.) https://doi.org/10.17650/2311-1267-2017-4-2-29-39
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