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조혈모세포이식 환자에서 흔히 보는 감염

Common Infectious Diseases in Hematopoietic Stem Cell Transplant Recipients

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참고문헌

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초록

조혈모세포이식은 다양한 악성 혈액종양과 면역 질환을 치료하기 위한 방법으로 널리 시행되고 있고, 의학의 발전과 함께 더 많은 질환을 치료하기 위한 다양한 기법이 개발되고 있다. 보존치료 역시 발전하여 환자들의 생존율이 개선되었으나, 감염 질환은 여전히 유병률, 사망률에 많은 부분을 차지하고 있다. 이식 후 감염 질환은 이식의 종류, 면역억제제, 이식편대숙주병 등에 따라, 시기에 따라 다를 수 있고, 특히 지역과 계절에 따라서도 특징을 가지게 된다. 이식 혹은 감염전문의 뿐만 아니라 1차 진료를 담당하는 의사들도 이식 후 감염 질환을 이해하는 것이 환자와 가족의 건강을 개선하는 지름길이라 믿고, 앞으로 관련있는 많은 사람들이 관심을 가지고 더욱 발전이 있기를 기대한다.

Abstract

Hematopoietic stem cell transplantation (HSCT) has improved the outcome of numerous malignant and non-malignant diseases. However, infectious diseases (IDs) still contributes the burden of morbidity and mortality significantly after both autologous and allogeneic HSCTs. IDs are usually classified by the time periods after HSCT; pre-engraftment period, immediate and late post-engraftment period. Kinds of IDs and their frequencies and distribution are dependent not only on the stem cell sources, conditioning regimens, presence of graft-versus-host diseases, but also on the region, prophylactic antibiotics, and so on. In this article, the common IDs after HSCT according to the time periods are reviewed. Additionally, it is tried to focus the recent Korean perspectives, for examples, tuberculosis, herpes zoster, respiratory virus infection-especially hope to be of help for the non-transplant specialists and/or primary physicians.

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