Clinical Characteristics and Nursing Methods of Patients with Acute Cutaneous Graft-Versus-host Disease after Allogeneic Hematopoietic Stem Cell Transplantation
LU Dan, HU Yan
Department of Hematology, West China Hospital Affiliated to Sichuan University,Chengdu, Sichuan 610041
Abstract：【Objective】 To investigate the clinical characteristics and nursing methods of patients with acute skin graft-versus-host disease (GVHD) after allogeneic hematopoietic stem cell transplantation. 【Methods】 The clinical characteristics of 42 patients with allogeneic hematopoietic stem cell transplantation who were treated in our hospital from January 2013 to January 2015 were retrospectively analyzed. The incidence, clinical characteristics and nursing methods of acute skin type GVHD were analyzed.【Results】 Among the 42 patients, 15 cases were complicated with acute skin GVHD, the incidence rate was 35.7%, including 5 males and 10 females. There were 5 cases of acute myeloid leukemia (AML) (33.3%), 2 cases of acute lymphoblastic leukemia(ALL) (13.3%), 4 cases of myelodysplastic syndrome (MDS) (26.7%), 2 cases of aplastic anemia (AA)(13.3%), 1 case of chronic myeloid leukemia (CML) (6.7%), 1 case of acute mixed cell leukemia (MAL)(6.7%). There were 13 sibling donors (86.7%) and 2 unrelated donors (13.3%). In this group, 15 cases of acute skin type GVHD rash appeared at the earliest 3 days after stem cell infusion, and the latest time was 38 days; the rash initially manifested as mild diffuse erythema and papules, similar to measles and scarlet fever like drug eruption, with slight pain or pruritus. The most common sites were palms, head and face, and behind ears. The severity of the lesions was grade Ⅰ and grade Ⅱ. All the 15 patients were treated with psychological nursing. After communication, their mood improved significantly, they were able to face the disease positively, and they were able to accept treatment and nursing with the best mentality. No serious infection occurred. The skin involved in 15 patients with acute GVHD was grade Ⅰ to Ⅱ. No skin blister and skin integrity damage occurred, and no medical adhesive related skin lesions occurred.Among the 15 patients, 13 patients' rash subsided and discharged after active treatment and careful nursing. 2 cases occurred after the reduction of methylprednisolone. The range of rash was obviously extended and the color became red obviously. Because the nurses found and handled the rash in time, the rash was quickly controlled, and 2 cases were obviously improved and discharged. Allogeneic hematopoietic stem cell transplantation was successfully performed in 15 patients with acute GVHD.【Conclusion】 Acute skin GVHD has certain clinical characteristics. Observing skin symptoms, early detection and intervention are helpful to improve the prognosis and ensure the successful completion of hematopoietic stem cell transplantation.
卢丹, 胡艳. 异基因造血干细胞移植后急性皮肤型移植物抗宿主病患者的临床特点及护理方法[J]. 医学临床研究, 2020, 37(8): 1201-1203.
LU Dan, HU Yan. Clinical Characteristics and Nursing Methods of Patients with Acute Cutaneous Graft-Versus-host Disease after Allogeneic Hematopoietic Stem Cell Transplantation. JOURNAL OF CLINICAL RESEARCH, 2020, 37(8): 1201-1203.
2020, Vol. 37 
