Fred Hutchinson Cancer Research Center & the University of Washington School of Medicine, 1100 Fairview Avenue N., Seattle, WA 98109-1024, USA.
Expert Rev Clin Immunol. 2012 May;8(4):373-81. doi: 10.1586/eci.12.18.
Hematopoietic cell transplantation (HCT) is the only therapy with curative potential for patients with myelodysplastic syndrome. Many conditioning regimens have been developed that, along with the use of cord blood or HLA-haploidentical donors, allow doctors to offer HCT to a growing proportion of patients. New classification schemes identify more narrowly characterized risk groups, which may facilitate decisions with regard to HCT. Disease stage and cytogenetics remain the major determinants of HCT outcome. The use of peripheral blood progenitor cells may offer an advantage over marrow for engraftment and relapse prevention, but graft-versus-host disease remains a problem. The age of patients undergoing HCT has increased significantly over the past 25 years, and comorbid conditions are the major patient characteristic impacting transplant success. Recent studies show that drugs used in the non-HCT setting may be beneficial in the context of HCT.
造血细胞移植（HCT）是唯一有治愈潜力的治疗方法，适用于骨髓增生异常综合征患者。已经开发出许多预处理方案，加上使用脐带血或 HLA 单倍体供体，使医生能够为越来越多的患者提供 HCT。新的分类方案确定了更具特征性的风险组，这可能有助于做出关于 HCT 的决策。疾病分期和细胞遗传学仍然是 HCT 结果的主要决定因素。与骨髓相比，使用外周血造血祖细胞可能在植入和预防复发方面具有优势，但移植物抗宿主病仍然是一个问题。过去 25 年来，接受 HCT 的患者年龄显著增加，合并症是影响移植成功的主要患者特征。最近的研究表明，非 HCT 环境中使用的药物在 HCT 背景下可能是有益的。
