vspВопросы современной педиатрииCurrent Pediatrics1682-55271682-5535Издательство «ПедиатрЪ»10.15690/vsp.v19i6.2148vsp-2513Research ArticleОБМЕН ОПЫТОМEXCHANGE OF EXPERIENCEКлинические особенности кожной формы острой реакции «трансплантат против хозяина» при аллогенной трансплантации гемопоэтических стволовых клеток у детей с онкогематологическими заболеваниямиClinical Features of Cutaneous Acute Graft-versus-Host Disease after Allogeneic Hematopoietic Stem Cells Transplantation in Children with Hemato-Oncological Diseaseshttps://orcid.org/0000-0001-5911-553XБелышеваТ. С.BelyshevaTatiana S.

Белышева Татьяна Сергеевна, доктор медицинских наук, ведущий научный сотрудник научно-консультативного отделения НИИ детской онкологии и гематологии

115478, Москва, Каширское ш., д. 24

t.belysheva@ronc.ruhttps://orcid.org/0000-0003-1091-1521АлиевТ. З.AlievTimur Z.https://orcid.org/0000-0002-1469-2365ВалиевТ. Т.ValievTimur T.https://orcid.org/0000-0003-2395-4045МачневаЕ. Б.MachnevaElena B.https://orcid.org/0000-0003-3797-5808СидороваН. В.SidorovaNatalia V.МурашкинН. Н.MurashkinNikolay N.https://orcid.org/0000-0002-2945-284XКиргизовК. И.KirgizovKirill I.https://orcid.org/0000-0001-6131-1783ВарфоломееваС. Р.VarfolomeevaSvetlana R.

Москва

Национальный медицинский исследовательский центр онкологии им. Н.Н. БлохинаРоссияN.N. Blokhin National Medical Research Center of OncologyRussian FederationНациональный медицинский исследовательский центр здоровья детей; Первый Московский государственный медицинский университет им. И.М. Сеченова (Сеченовский Университет); Центральная государственная медицинская академия Управления делами Президента РФ; НИИ педиатрии и охраны здоровья детей ЦКБ РАНРоссияNational Medical Research Center of Children’s Health; Sechenov First Moscow State Medical University (Sechenov University); Central State Medical Academy of Department of Presidential Affairs; Research Institute of Pediatrics and Children’s Health in “Central Clinical Hospital of the Russian Academy of Sciences”Russian Federation202026122020196500508Copyright © Белышева Т.С., Алиев Т.З., Валиев Т.Т., Мачнева Е.Б., Сидорова Н.В., Мурашкин Н.Н., Киргизов К.И., Варфоломеева С.Р., 20202020Белышева Т.С., Алиев Т.З., Валиев Т.Т., Мачнева Е.Б., Сидорова Н.В., Мурашкин Н.Н., Киргизов К.И., Варфоломеева С.Р.Belysheva T.S., Aliev T.Z., Valiev T.T., Machneva E.B., Sidorova N.V., Murashkin N.N., Kirgizov K.I., Varfolomeeva S.R.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://vsp.spr-journal.ru/jour/article/view/2513

Реакция «трансплантат против хозяина» (РТПХ) — частое осложнение, возникает у половины больных после аллогенной трансплантации гемопоэтических стволовых клеток (ТГСК), является одной из основных причин смертности пациентов, не связанной с рецидивом основного заболевания. Поражение кожи в симптомокомплексе острой РТПХ развивается в течение первых 100 дней после ТГСК, представляет собой сложную диагностическую и терапевтическую проблему. Выраженный иммуносупрессивный статус детей в раннем посттрансплантационном периоде усиливает и видоизменяет течение дерматозов, инфекционных поражений, проявлений медикаментозной токсичности, приводя к запуску иммуноаллергических процессов с возможностью трансформации в генерализованные жизнеугрожающие поражения кожи и слизистых оболочек. В то же время токсические, аллергические, инфекционные поражения кожи могут присутствовать в клинической картине одномоментно или развиваться последовательно. В связи с относительно небольшой частотой проводимых ТГСК у детей с онкологическими заболеваниями описание клинической картины поражений кожи при острой РТПХ представляет несомненный интерес и научно-практическую значимость. В статье обобщены данные об этиологии, патогенезе, клинических формах, методах диагностики и лечения кожных осложнений раннего посттрансплантационного периода при ТГСК.

The graft-versus-host disease (GvHD) is frequent complication, it occurs in 50% of patients after allogeneic hematopoietic stem cell transplantation (HSCT) and it is one of the major causes of mortality not associated with disease recurrence. Skin lesion in the symptom complex of acute GvHD develops within the first 100 days after HSCT, and it is complicated diagnostic and therapeutic problem. Significant immunosuppressive status of children during the posttransplant period enhances and changes the course of dermatoses, infections, drug toxicity. Finally, it can lead to immunoallergic processes with possible development to generalized life-threatening diseases of the skin and mucous membranes. Meanwhile, toxic, allergic and infectious skin lesions can be present simultaneously or develop sequentially. The description of the clinical picture of skin lesions in acute GvHD is really crucial and has scientific and practical significance due to relatively small frequency of HSCT in children with oncology diseases. The article summarizes data on etiology, pathogenesis, clinical forms, diagnostic and treatment methods of cutaneous complications of the early post-transplantation period after HSCT.

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