Legare R D, Gilliland D G
Brigham and Women's Hospital, Longwood Medical Research Center, Hematology-Oncology Division, Boston, MA, USA.
Curr Opin Hematol. 1995 Jul;2(4):283-92. doi: 10.1097/00062752-199502040-00008.
Myelodysplastic syndrome continues to present a formidable clinical challenge. Despite considerable effort, no therapy apart from allogeneic bone marrow transplantation has been shown to prolong survival. Lack of effective therapy for myelodysplastic syndrome is of further concern given recent reports on the high incidence of myelodysplastic syndrome in patients undergoing intensive chemotherapy and radiation therapy for other malignancies. However, significant strides have been made in the past year toward understanding the molecular pathogenesis of some forms of myelodysplastic syndrome, as well as developing new approaches for therapy of myelodysplastic syndrome. This review highlights recent advances in the molecular genetics of myelodysplastic syndrome, including clonality analysis and identification of genes that are causally implicated in the pathogenesis of myelodysplastic syndrome; results from recent clinical trials for therapy of myelodysplastic syndrome using growth factors, chemotherapy or both; and recent literature on therapy-related myelodysplastic syndrome in intensively treated patients.
骨髓增生异常综合征仍然是一个严峻的临床挑战。尽管付出了巨大努力，但除了异基因骨髓移植外，尚无其他疗法被证明能延长生存期。鉴于最近有关在接受其他恶性肿瘤强化化疗和放疗的患者中骨髓增生异常综合征高发率的报道，缺乏针对骨髓增生异常综合征的有效疗法更令人担忧。然而，在过去一年里，在了解某些形式的骨髓增生异常综合征的分子发病机制以及开发治疗骨髓增生异常综合征的新方法方面取得了重大进展。本综述重点介绍了骨髓增生异常综合征分子遗传学的最新进展，包括克隆性分析以及鉴定与骨髓增生异常综合征发病机制有因果关系的基因；近期使用生长因子、化疗或两者联合治疗骨髓增生异常综合征的临床试验结果；以及关于接受强化治疗患者中治疗相关骨髓增生异常综合征的最新文献。
