Chiu Shao-Chih, Liu Hua-Hsing, Chen Chia-Ling, Chen Pin-Ru, Liu Ming-Chao, Lin Shinn-Zong, Chang Ko-Tung
Graduate Institute of Immunology, China Medical University, Taichung, Taiwan.
Cell Transplant. 2015;24(3):349-66. doi: 10.3727/096368915X686850. Epub 2015 Feb 2.
Extramedullary hematopoiesis (EMH) is a pathological process secondary to underlying bone marrow (BM) insufficiency in adults. It is characterized by the emergence of multipotent hematopoietic progenitors scattered around the affected tissue, most likely in the spleen, liver, and lymph node, etc. EMH in patients frequently receives less medical attention and is neglected unless a compressive or obstructive hematopoietic mass appears to endanger the patient's life. However, on a biological basis, EMH reflects the alteration of relationships among hematopoietic stem and progenitor cells (HSPCs) and their original and new microenvironments. The ability of hematopoietic stem cells (HSCs) to mobilize from the bone marrow and to accommodate and function in extramedullary tissues is rather complicated and far from our current understanding. Fortunately, many reports from the studies of drugs and genetics using animals have incidentally found EMH to be involved. Thereby, the molecular basis of EMH could further be elucidated from those animals after cross-comparison. A deeper understanding of the extramedullary hematopoietic niche could help expand stem cells in vitro and establish a better treatment in patients for stem cell transplantation.
髓外造血(EMH)是成人潜在骨髓(BM)功能不全继发的病理过程。其特征是多能造血祖细胞出现在受影响组织周围,最常见于脾脏、肝脏和淋巴结等。患者的EMH通常较少受到医学关注且被忽视,除非出现压迫性或阻塞性造血肿块危及患者生命。然而,从生物学角度来看,EMH反映了造血干细胞和祖细胞(HSPCs)与其原始和新微环境之间关系的改变。造血干细胞(HSCs)从骨髓动员并在髓外组织中定居和发挥功能的能力相当复杂,远非我们目前所理解的那样。幸运的是,许多使用动物进行的药物和遗传学研究报告偶然发现EMH与之相关。因此,通过交叉比较,可从这些动物中进一步阐明EMH的分子基础。对髓外造血微环境的更深入了解有助于在体外扩增干细胞,并为患者建立更好的干细胞移植治疗方法。