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Enfermedad injerto contra huésped - Treatment

Nombres alternativos

EICH

Tratamiento:

El objetivo del tratamiento es inhibir la respuesta inmunitaria sin dañar las nuevas células. Los medicamentos que se utilizan comúnmente abarcan metotrexato, ciclosporina, tacrolimus, sirolimus, ATG y alemtuzumab, ya sea solos o combinados.

Los corticosteroides en altas dosis son el tratamiento más eficaz para la EICH aguda. A los pacientes que no responden a los esteroides se les administran anticuerpos contra las células T y otros medicamentos.

El tratamiento de la EICH crónica incluye prednisona (un esteroide) con o sin ciclosporina. Otros tratamientos abarcan mofetil micofenolato (CellCept), sirolimus (Rapamycin) y tacrolimus (Prograf).

Expectativas (pronóstico):

El pronóstico de una persona depende de la gravedad de la afección. Algunos casos de EICH pueden llevar a la muerte.

Muchos casos, ya sea agudos o crónicos, pueden tratarse con éxito. Algunas veces, el tratamiento de la afección puede llevar a complicaciones severas.

El tratamiento exitoso de EICH no garantiza que el trasplante de la médula ósea en sí vaya a ser efectivo para tratar la enfermedad original.

Complicaciones:

  • Colestasis
  • Muerte
  • Daño al hígado, pulmón o tubo digestivo que puede ser de moderado a grave
  • Infección grave
  • Enfermedad pulmonar grave

Situaciones que requieren asistencia médica:

Si usted se ha hecho un trasplante de médula ósea o células madre, llame al médico inmediatamente si aparece cualquier síntoma inusual, como:

  • Diarrea
  • Dificultad para respirar
  • Erupción cutánea
  • Cólicos estomacales
  • Color amarillento de la piel o los ojos (ictericia)
  • Reviewed last on: 6/2/2010
  • David C. Dugdale, III, MD, Professor of Medicine, Division of General Medicine, Department of Medicine, University of Washington School of Medicine; Yi-Bin Chen, MD, Leukemia/Bone Marrow Transplant Program, Massachusetts General Hospital. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.

Referencias

Hoffman R, Benz EJ, Shattil SS, et al, eds. Hematology: Basic Principles and Practice. 5th ed. Philadelphia, Pa: Elsevier Churchill Livingstone; 2008.

Sykes M. Transplantation immunology. In Goldman L, Ausiello D, eds. Cecil Medicine. 23rd ed. Philadelphia, Pa: Saunders Elsevier; 2007:chap 46.

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