Januszewicz E H, Firkin F C
University of Melbourne Department of Medicine, St Vincent's Hospital, Vic, Australia.
Aust N Z J Med. 1988 Aug;18(5):705-11. doi: 10.1111/j.1445-5994.1988.tb00158.x.
In this review we have discussed the data which indicates that differentiation can indeed occur to a limited degree in the neoplastic cells in acute leukemia and myelodysplastic syndromes. Attempts to increase the degree of differentiation as an approach to the treatment of these disorders have utilised a variety of chemical agents which have been reported to exert such an effect in vitro. Analysis of the results, however, indicates that beneficial effects of these agents in patients is due to cytotoxic action which selectively reduces the neoplastic cell population. Leukemic cells can also undergo incomplete differentiation in vitro when exposed to appropriate growth factors, which raises the question of whether leukemia and myelodysplasia can be treated by the induction of differentiation in the malignant cells following the administration of these agents. This question, and questions about the nature of complete remission, will be answered in the coming years by clinical trials of growth factors, and further studies of the DNA in mature cells to analyse whether these cells are derived from leukemic progenitors.
在本综述中，我们讨论了相关数据，这些数据表明在急性白血病和骨髓增生异常综合征的肿瘤细胞中，分化确实能在一定程度上发生。试图通过提高分化程度来治疗这些疾病的方法使用了多种化学药物，据报道这些药物在体外能发挥这样的作用。然而，对结果的分析表明，这些药物对患者的有益作用是由于其细胞毒性作用，这种作用选择性地减少了肿瘤细胞群体。当暴露于适当的生长因子时，白血病细胞在体外也能发生不完全分化，这就提出了一个问题，即白血病和骨髓发育异常是否可以通过在给予这些药物后诱导恶性细胞分化来治疗。这个问题以及关于完全缓解本质的问题，将在未来几年通过生长因子的临床试验以及对成熟细胞中DNA的进一步研究来回答，以分析这些细胞是否源自白血病祖细胞。
