造血干细胞移植在克罗恩病中的应用进展

Application Progress of Hematopoietic Stem Cell Transplantation in Crohn′s Disease

克罗恩病(CD)是一种慢性、复发性、难治愈的肠道炎性疾病。目前CD尚无治愈方法,主流疗法是口服或注射药物,如5-氨基水杨酸(5-ASA)、糖皮质激素、免疫抑制剂以及生物制剂。但随着治疗时间的延长,许多患者对这些药物不耐受或失应答,同时亦失去了手术机会。CD的发病、进展以及预后与免疫紊乱的密切相关性使造血干细胞移植(HSCT)应用于CD治疗成为可能。移植过程中表现出的高不良反应发生率和高复发率,甚至致死率,使HSCT并不推荐用于CD的初始治疗,更适用于多种药物治疗无效且失去手术机会或本身合并血液系统疾病或自身免疫病的患者,可作为临床的一种补救治疗。本文就HSCT在CD中的应用进展作一综述。

Crohn´s disease(CD)is a chronic,recurrent,and difficult-to-cure inflammatory disease of intestine.Currently,there is no cure for CD,and the mainstream therapy is oral or injectable drugs,such as 5-aminosalicylic acid(5-ASA),glucocorticoids,immunosuppressants,and biological agents.However,with the extension of treatment time,many patients are intolerant to drugs or lose response,also lose the opportunity for surgery.The pathogenesis,progression and prognosis of CD are closely related to immune disorders,which makes it possible for hematopoietic stem cell transplantation(HSCT)to be applied in the treatment of CD.Due to the high incidence of adverse reactions,high recurrence rate,and even fatality,HSCT is not recommended for the initial treatment of CD,but is more suitable for patients with ineffective multi-drug treatment and lost the opportunity for surgery or patients with hematological system diseases or autoimmune diseases.It can be used as a clinical remedial treatment.This article reviewed the application progress of HSCT in CD.