Boogaerts M A
Department of Hematology, University Hospital Leuven, Belgium.
Blut. 1989 Jun;58(6):265-70. doi: 10.1007/BF00320163.
The progress in the therapy of the myelodysplastic syndromes has been far from spectacular during recent years. No currently available treatment has been shown to be consistently effective in producing sustained improvement in hematopoiesis or in delaying leukemic evolution. With regard to both quantity and quality of life, no other treatment has been proven superior to classical supportive treatment, with the possible exception of bone marrow transplantation in younger patients. While in selected cases anecdotal successes have been noted with the use of hormonal therapy, some differentiation inducers, e.g. vitamin A- en D-analogues, have not hold their promises in placebo controlled trials. Attempts to induce complete remissions in MDS with antileukemic treatment have usually been unsuccessful. Toxicity is substantial and a considerable proportion of patients fare worse with chemotherapy than with standard supportive care. Recently, a flood of reports has appeared on the use of biological response modifiers e.g. cytokines and growth factors in the treatment of MDS. Perhaps some of these hold promises for a new era in MDS, but the data are preliminary and no follow-up on long term survival is at hand.
近年来，骨髓增生异常综合征的治疗进展并不显著。目前尚无任何一种治疗方法被证明能持续有效地改善造血功能或延缓白血病进展。在生活质量的数量和质量方面，除了年轻患者的骨髓移植可能是个例外，没有其他治疗方法被证明优于传统的支持性治疗。虽然在某些病例中使用激素治疗取得了一些成功的案例，但一些分化诱导剂，如维生素A和D类似物，在安慰剂对照试验中并未达到预期效果。试图通过抗白血病治疗诱导骨髓增生异常综合征完全缓解通常是不成功的。毒性很大，相当一部分患者接受化疗后的情况比接受标准支持性治疗更差。最近，大量关于使用生物反应调节剂（如细胞因子和生长因子）治疗骨髓增生异常综合征的报道涌现。也许其中一些对骨髓增生异常综合征的新时代有希望，但数据是初步的，目前尚无长期生存的随访结果。
