天津医药

天津医药 ›› 2018, Vol. 46 ›› Issue (8): 794-798.doi: 10.11958/20180561

• 专题-专家论坛 • 上一篇    下一篇

骨髓增生异常综合征贫血原因及治疗策略

韩冰， 李红敏， 陈芳菲， 伍洁   

  1. 北京协和医院血液科 （邮编100730）
  • 收稿日期:2018-04-09 修回日期:2018-07-17 出版日期:2018-08-15 发布日期:2018-08-23
  • 通讯作者: 韩冰 E-mail:hanbing_li@sina.com.cn

Etiology and treatment strategies of anemia in myelodysplastic syndromes

HAN Bing, LI Hong-min, CHEN Fang-fei, WU Jie   

  1. Department of Hematology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100730, China
  • Received:2018-04-09 Revised:2018-07-17 Published:2018-08-15 Online:2018-08-23

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摘要： 骨髓增生异常综合征 （MDS） 是一组高度异质性疾病， 贫血是MDS常见的临床表现， 也是影响MDS患者生存及生活质量的重要因素。MDS贫血的发病机制复杂， 患者的贫血可以是多种因素的结果。本文论述了MDS常见的贫血原因， 包括异常克隆的扩增、 免疫异常、 5q-的造血异常、 无效造血和铁过载等。针对不同原因的贫血， 可以采用促红细胞生成素、 免疫抑制剂、 祛铁治疗、 免疫调节治疗、 转化生长因子-β （TGF-β） 通路阻断剂、 去甲基化药物治疗和造血干细胞移植等策略。

关键词: 骨髓增生异常综合征, 贫血, 原因, 治疗策略

Abstract: Myelodysplastic syndrome (MDS) is a group of highly heterogeneous diseases. Anemia is the most common manifestation of MDS, which is also an important factor affecting the survival and quality of life in MDS patients. Different factors are involved in the pathogenesis of anemia of MDS, and for a particular patient, anemia maybe the results of multiple factors. In current review, we summarized the common reasons for MDS anemia including expansion of abnormal clone, immune regulation dysfunction, abnormal hematopoiesis concerning with 5q-, ineffective hematopoiesis and iron overload. Erythropoietin (EPO), immunosuppressive agent, iron chelators, immunomodulatory, transforming growth factor beta (TGF- β) pathway inhibitor, demethylation drugs and hematopoiesis stem cell transplantation may help to improve the anemia of different causes in MDS patients.

Key words: myelodysplastic syndromes, anemia, cause of disease, origin of a disease