骨髓增生异常综合征中的免疫调节

Immunomodulation in myelodysplastic syndromes.

作者信息

Sekeres Mikkael A, List Alan

机构信息

Cleveland Clinic Lerner College of Medicine, Department of Hematologic Malignancies and Blood Disorders, Taussig Cancer Center, Cleveland Clinic Foundation, Desk R35, 9500 Euclid Avenue, Cleveland, Ohio 44195, USA.

出版信息

Best Pract Res Clin Haematol. 2006;19(4):757-67. doi: 10.1016/j.beha.2006.06.001.

DOI:10.1016/j.beha.2006.06.001

PMID:16997181

Abstract

The myelodysplastic syndromes (MDS) - bone-marrow stem-cell malignancies that share pathogenetic overlap with acute myeloid leukemia - are characterized by peripheral-blood cytopenias and, in more advanced subtypes, varied degrees of maturation arrest. Premature apoptosis of bone-marrow cellular elements contributes to ineffective hematopoiesis, which is exacerbated by stromal production of inflammatory cytokines. Abrogation of the effects of these cytokines represents an area of active clinical research, particularly in the treatment of low-risk MDS. Agents such as thalidomide, lenalidomide, and infliximab have shown promising efficacy and tolerability in clinical trials, and may represent a springboard for future treatment combinations.

摘要

骨髓增生异常综合征（MDS）是一类骨髓干细胞恶性肿瘤，与急性髓系白血病存在共同的发病机制，其特征为外周血细胞减少，在更晚期的亚型中还伴有不同程度的成熟停滞。骨髓细胞成分的过早凋亡导致无效造血，而基质细胞产生的炎性细胞因子会加剧这一情况。消除这些细胞因子的作用是当前临床研究的一个活跃领域，尤其是在低危MDS的治疗方面。沙利度胺、来那度胺和英夫利昔单抗等药物在临床试验中已显示出有前景的疗效和耐受性，可能成为未来联合治疗的一个跳板。