Abstract:  The myelodysplastic syndrome (MDS) is a heterogeneous group of clonal disorders originating from hematopoietic stem cells (HSC), characterized by unilineage or multilineage dysplasia of myeloid cells, ineffective hematopoiesis, peripheral blood cytopenias and high risk of transform into acute myeloid leukemia (AML). The pathogenesis, hematopoietic function change and prognosis of MDS are closely related to the bone marrow microenvironment. Bone marrow microenvironment is a complex network system, among them, stromal cells including abnormal morphology and function of mesenchymal stem cells, impaired osteoblast differentiation, increased number of vascular endothelial cells, and decreased number of monocytes /macrophages can promote the pathogenesis of MDS. The abnormal expression of cytokines such as tumor necrosis factor-α (TNF-α), vascular endothelial growth factor (VEGF) and stromal cell-derived factor-1 (SDF-1) are also closely related to the pathogenesis of MDS. Low expression of genes such as Dicer1, high expression of AURKA, and low expression of SPINT2 all contribute to the pathogenesis of MDS. Aberrant activation of Wnt/β-catenin signaling pathways, abnormal PI3K/AKT and Hh signaling pathways are also involved in the pathogenesis and progression of MDS. The study of the interaction between MDS and bone marrow microenvironment will further elucidate the pathogenesis, progress and prognosis of the disease, and will contribute to the development of targeted therapy. This review provides the research progress of bone marrow microenvironment stromal cells, cytokines, genes, and signaling pathway abnormalities in MDS.

Key words:  bone marrow, myelodysplastic syndromes, microenvironment, review