medsovetМедицинский СоветMeditsinskiy sovet = Medical Council2079-701X2658-5790REMEDIUM GROUP Ltd.10.21518/2079-701X-2016-1-136-139medsovet-23Research ArticleТРУДНЫЙ ДИАГНОЗDIFFICULT DIAGNOSISБолезнь трансплантат против хозяина после аллогенной трансплантации гемопоэтических стволовых клеток у детейGraft-versus-host disease after allogeneic hematopoietic stem cell transplantation in childrenСкворцоваЮ. В.SkvortsovaY. V.noemail@neicon.ruБалашовД. Н.BalashovD. N.noemail@neicon.ruДелягинВ. М.DelyaginV. M.noemail@neicon.ruФедеральный научно-клинический центр детской гематологии, онкологии и иммунологии им. Дмитрия Рогачева МЗ РФРоссияFederal Research and Clinical Centre of Pediatric Hematology, Oncology and Immunology named after Dmitry RogachevRussian Federation20163012201611136139Copyright © Скворцова Ю.В., Балашов Д.Н., Делягин В.М., 20162016Скворцова Ю.В., Балашов Д.Н., Делягин В.М.Skvortsova Y.V., Balashov D.N., Delyagin V.M.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.med-sovet.pro/jour/article/view/23

Ежегодно в мире совершается не менее 60 тыс. трансплантаций гемопоэтических стволовых клеток (ТГСК). Исход ТГСК во многом определяется вероятностью развития и степенью тяжести реакции (болезни) трансплантат против хозяина (РТПХ). Лечение включает в себя кортикостероиды. При стероид-рефрактерной РТПХ используются антитимоцитарный глобулин, экстракорпоральный фотофе-рез, моноклональные антитела к интерлейкинам или их рецепторам, метатрексат, циклоспорин, такролимус, сиролимус, антитимоцитарный глобулин и др. Привлекает внимание назначение мико-фенолата мофетила, эфира микофенольной кислоты, блокирующего пролиферацию Т- и В-лимфоцитов. Существует мнение, что у пациентов, рефрактерных к кортикостероидам, оправданно применение микофенолата мофетила изолированно или в сочетании с циклоспорином, такролимусом.

Up to 60 thousand hematopoietic stem cell transplantations (HSCT) are carried out globally all over the world. The outcome of HSCT is largely determined by the probability and severity of the graft-versus-host reaction/disease (GVHD). Treatment involves corticosteroids. Antithymocyte globulin, extracorporeal photopheresis, monoclonal antibodies to interleukins or their receptors, methotrexate, cyclosporine, tacrolimus, sirolimus, antithymocyte globulin, etc. are used in steroid-refractory GVHD. It is worth to mention that mycophenolate mofetil, esther of mycophenolic acid, blocks proliferation of T and B lymphocytes. In patients who are refractory to corticosteroids, the use of mycophenolate mofetil in isolation or in combination with cyclosporine, tacrolimus seems to be justified.

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