继发性中性粒细胞减少症

Secondary Neutropenias.

作者信息

Ward Alister C

机构信息

School of Medicine, Deakin University, Waurn Ponds, VIC 3216, Australia.

Institute for Mental and Physical Health and Clinical Translation (IMPACT), Deakin University, Waurn Ponds, VIC 3216, Australia.

出版信息

Biomedicines. 2025 Feb 17;13(2):497. doi: 10.3390/biomedicines13020497.

Abstract

Neutrophils are a critical component of immunity, particularly against bacteria and other pathogens, but also in inflammation and tissue repair. As a consequence, individuals with neutropenia, defined by a reduction in absolute neutrophil counts, exhibit a strong propensity to severe infections that typically present with muted symptoms. Neutropenias encompass a heterogeneous set of disorders, comprising primary neutropenias, in which specific genes are mutated, and the more common secondary neutropenias, which have diverse non-genetic causes. These include hematological and other cancers, involving both direct effects of the cancer itself and indirect impacts via the chemotherapeutic, biological agents and cell-based approaches used for treatment. Other significant causes of secondary neutropenias are non-chemotherapeutic drugs, autoimmune and other immune diseases, infections and nutrient deficiencies. These collectively act by impacting neutrophil production in the bone marrow and/or destruction throughout the body. This review describes the biological and clinical manifestations of secondary neutropenias, detailing their underlying causes and management, with a discussion of alternative and emerging therapeutic approaches.

摘要

中性粒细胞是免疫的关键组成部分,尤其在抵御细菌和其他病原体方面发挥作用,同时也参与炎症反应和组织修复过程。因此,因绝对中性粒细胞计数减少而定义为中性粒细胞减少症的个体,极易发生严重感染,且感染症状通常不明显。中性粒细胞减少症涵盖了一系列异质性疾病,包括特定基因发生突变的原发性中性粒细胞减少症,以及更为常见的具有多种非遗传病因的继发性中性粒细胞减少症。这些病因包括血液系统和其他癌症,涉及癌症本身的直接影响以及通过用于治疗的化疗药物、生物制剂和基于细胞的方法产生的间接影响。继发性中性粒细胞减少症的其他重要病因包括非化疗药物、自身免疫性疾病和其他免疫疾病、感染以及营养缺乏。这些因素共同作用,影响骨髓中中性粒细胞的生成和/或全身的中性粒细胞破坏。本综述描述了继发性中性粒细胞减少症的生物学和临床表现,详细阐述了其潜在病因和管理方法,并讨论了替代疗法和新兴治疗方法。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7252/11853056/20d1a8318f38/biomedicines-13-00497-g001.jpg

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