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真性红细胞增多症预后及治疗的最新进展

Recent advances in prognostication and treatment of polycythemia vera.

作者信息

Marcellino Bridget K, Hoffman Ronald

机构信息

Division of Hematology and Medical Oncology, Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, One Gustave L. Levy Place, Box 1079, New York, USA.

出版信息

Fac Rev. 2021 Mar 12;10:29. doi: 10.12703/r/10-29. eCollection 2021.

Abstract

Polycythemia vera (PV) is a -negative myeloproliferative neoplasm marked by acquisition of an activating mutation of , which leads to not only erythrocytosis but also frequently to leukocytosis and thrombocytosis, and is associated with a high symptom burden and increased thrombotic risk. PV has the potential to progress to myelofibrosis or an aggressive form of acute myeloid leukemia. Mutational profiling of patients with PV has led to the development of risk stratification tools to determine an individual's risk of developing progressive disease. Although the current goals of PV treatment are to alleviate symptoms and reduce thrombotic risk, there are growing efforts to identify disease-modifying agents which will also prevent progression of disease. Here, we give an overview of the developing prognostic tools and therapeutic landscape for PV, focusing on four drug classes: pegylated interferon-alpha 2, MDM2 antagonists, hepcidin mimetics, and histone deacetylase inhibitors.

摘要

真性红细胞增多症(PV)是一种JAK2阴性的骨髓增殖性肿瘤,其特征是获得JAK2激活突变,这不仅导致红细胞增多,还常常导致白细胞增多和血小板增多,并伴有高症状负担和血栓形成风险增加。PV有可能进展为骨髓纤维化或侵袭性急性髓系白血病。对PV患者的突变分析已导致开发风险分层工具,以确定个体发生进展性疾病的风险。尽管目前PV治疗的目标是缓解症状和降低血栓形成风险,但人们越来越努力寻找能够预防疾病进展的疾病修饰药物。在此,我们概述了PV不断发展的预后工具和治疗前景,重点介绍四类药物:聚乙二醇化干扰素-α2、MDM2拮抗剂、铁调素模拟物和组蛋白去乙酰化酶抑制剂。

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