Baraldi-Junkins C A, Beck A C, Rothstein G
Salt Lake City Geriatric Research, Education, and Clinical Center, Salt Lake City Veterans Administration Medical Center, Utah, USA.
Hematol Oncol Clin North Am. 2000 Feb;14(1):45-61, viii. doi: 10.1016/s0889-8588(05)70277-x.
Impaired hematopoiesis and dysregulated cytokine expression have important implications for cancer in the elderly. In aged people, hematopoiesis is dysregulated and becomes paradoxically down-modulated under periods of increased hematopoietic demand. This down-modulation may explain, at least in part, the increased incidence of anemia in the elderly, although the cause of anemia can usually be identified in these patients and frequently reversed with targeted therapy. An age-associated decrease in the expression of interleukin-2 may contribute to impaired cellular immunity. Additionally, the increased interleukin-6 production frequently found in the elderly may participate in promoting the survival and proliferation of malignant myeloma and in inducing resistance by myeloma cells to therapies that act through apoptosis. Dysregulation of the expression of these and other cytokines may be a mechanism contributing to age-related impairment of the hematopoietic response, the genesis and therapeutic resistance of specific malignancies, and cancer cachexia.
造血功能受损和细胞因子表达失调对老年癌症具有重要影响。在老年人中，造血功能失调，并且在造血需求增加期间反常地受到下调。这种下调至少可以部分解释老年人贫血发病率的增加，尽管这些患者贫血的原因通常可以确定，并且通过靶向治疗常常可以逆转。白细胞介素-2表达的年龄相关性下降可能导致细胞免疫受损。此外，老年人中常见的白细胞介素-6产生增加可能参与促进恶性骨髓瘤的存活和增殖，并诱导骨髓瘤细胞对通过凋亡起作用的疗法产生抗性。这些和其他细胞因子表达的失调可能是导致与年龄相关的造血反应受损、特定恶性肿瘤的发生和治疗抗性以及癌症恶病质的一种机制。
