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获得性骨髓增生异常综合征和再生障碍性全血细胞减少症的生理学及治疗新见解。

New insights into the physiology and treatment of acquired myelodysplastic syndromes and aplastic pancytopenia.

作者信息

Weiss Douglas J

机构信息

Department of Veterinary Pathobiology, College of Veterinary Medicine, University of Minnesota, St. Paul, MN 55108, USA.

出版信息

Vet Clin North Am Small Anim Pract. 2003 Nov;33(6):1317-34. doi: 10.1016/s0195-5616(03)00094-9.

Abstract

MDS are a diverse group of primary and secondary bone marrow disorders that are characterized by cytopenias in blood, prominent dysplastic features in blood or bone marrow, and normal or hypercellular bone marrow. MDS in cats are typically associated with FeLV infection. Dogs with MDS-RC and MDS-Er seem to respond to erythropoietin administration and have prolonged survival. Dogs with MDS-EB respond poorly to present treatments, and survival is short. Prognosis and probability of progression to acute myelogenous leukemia can be predicted based on the percentage of myeloblasts in bone marrow. Several experimental therapeutic modalities in human beings have been described that may be useful in treating MDS-EB in dogs and cats. Aplastic pancytopenia is a relatively rare disorder in dogs and cats. Causes include Ehrlichia spp, Parvovirus, and FeLV infections; sepsis; chronic renal failure; drug and toxin exposure; and idiopathic causes. Diagnosis is based on identification of multiple cytopenias in the blood and hypoplastic/aplastic bone marrow, with the marrow space replaced by adipose tissue. Treatment and outcome are dependent on determining the underlying cause of the bone marrow failure.

摘要

骨髓增生异常综合征(MDS)是一组多样的原发性和继发性骨髓疾病,其特征为血液中血细胞减少、血液或骨髓中显著的发育异常特征以及骨髓正常或细胞增多。猫的MDS通常与猫白血病病毒(FeLV)感染有关。患有难治性血细胞减少伴多系发育异常(MDS-RC)和难治性贫血伴环形铁粒幼细胞增多(MDS-Er)的犬似乎对促红细胞生成素治疗有反应,且生存期延长。患有骨髓原始细胞增多伴多系发育异常(MDS-EB)的犬对目前的治疗反应不佳,生存期短。可根据骨髓中原始粒细胞的百分比预测预后及进展为急性髓系白血病的可能性。已描述了几种人类的实验性治疗方法,可能对治疗犬猫的MDS-EB有用。再生障碍性全血细胞减少症在犬猫中是一种相对罕见的疾病。病因包括埃立克体属感染、细小病毒感染、FeLV感染;败血症;慢性肾衰竭;药物和毒素暴露;以及特发性病因。诊断基于血液中多种血细胞减少以及骨髓发育不全/再生障碍的鉴定,骨髓腔被脂肪组织取代。治疗和预后取决于确定骨髓衰竭的潜在原因。

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