Chung Stephen S, Park Christopher Y
Leukemia Service, Memorial Sloan Kettering Cancer Center, New York, NY; and.
Department of Pathology, New York University School of Medicine, New York, NY.
Blood Adv. 2017 Dec 8;1(26):2572-2578. doi: 10.1182/bloodadvances.2017009852. eCollection 2017 Dec 12.
The aging hematopoietic system undergoes numerous changes, including reduced production of red blood cells and lymphocytes as well as a relative increase in the production of myeloid cells. Emerging evidence indicates that many of these changes are due to selection pressures from cell-intrinsic and cell-extrinsic factors that result in clonal shifts in the hematopoietic stem cell (HSC) pool, resulting in predominant HSC clones that exhibit the functional characteristics associated with HSC aging. Given the recent descriptions of clonal hematopoiesis in aged populations, the increased risk of developing hematologic malignancies in individuals with clonal hematopoiesis, and the many similarities in hematopoietic aging and acquired bone marrow failure (BMF) syndromes, such as myelodysplastic syndromes (MDS), this raises significant questions regarding the relationship between aging hematopoiesis and MDS, including the factors that regulate HSC aging, whether clonal hematopoiesis is required for the development of MDS, and even whether BMF is an inevitable consequence of aging. In this article, we will review our current understanding of these processes and the potential intersections among them.
衰老的造血系统会经历众多变化，包括红细胞和淋巴细胞生成减少以及髓系细胞生成相对增加。新出现的证据表明，这些变化中的许多是由于细胞内在和外在因素的选择压力导致造血干细胞（HSC）库中的克隆转变，从而产生具有与HSC衰老相关功能特征的优势HSC克隆。鉴于近期对老年人群中克隆性造血的描述、克隆性造血个体发生血液系统恶性肿瘤的风险增加，以及造血衰老与获得性骨髓衰竭（BMF）综合征（如骨髓增生异常综合征（MDS））的诸多相似之处，这引发了关于衰老造血与MDS之间关系的重大问题，包括调节HSC衰老的因素、MDS的发生是否需要克隆性造血，甚至BMF是否是衰老的必然结果。在本文中，我们将综述我们目前对这些过程的理解以及它们之间的潜在交叉点。
