巨红细胞性贫血

IF 3.1 3区 医学 Q2 HEMATOLOGY Current Opinion in Hematology Pub Date : 2024-05-01 Epub Date: 2024-02-07 DOI:10.1097/MOH.0000000000000804
Mark J Koury, Daniel J Hausrath
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引用次数: 0

摘要

回顾的目的:上个世纪以来,与巨幼红细胞性贫血相关的疾病在不断变化,目前有越来越多的患者患有血液病,包括恶性肿瘤和骨髓增生异常综合征。巨幼红细胞性贫血发生的细胞内机制有助于理解正常的红细胞生成。红细胞祖细胞和前体细胞对这些疾病的适应会导致红细胞数量减少但体积增大,了解这些机制可为可能的治疗提供信息:遗传性和获得性骨髓疾病主要涉及红细胞分裂受损或延迟,或对基本红细胞细胞缺陷的继发性适应,从而导致细胞分裂延长:在骨髓衰竭疾病中,红细胞分化早期阶段铁和血红素的大量积聚使处于这些阶段的细胞特别容易死亡,但能在终末分化早期阶段存活下来的红细胞产生的红细胞数量较少但体积较大,临床上被认定为巨幼红细胞性贫血。其他限制 DNA 合成所需的脱氧核苷的疾病会影响更多的红细胞,但也会导致巨红细胞性贫血。其他疾病中巨幼红细胞症的来源仍不确定。
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Macrocytic anemias.

Purpose of review: Over the last century, the diseases associated with macrocytic anemia have been changing with more patients currently having hematological diseases including malignancies and myelodysplastic syndrome. The intracellular mechanisms underlying the development of anemia with macrocytosis can help in understanding normal erythropoiesis. Adaptations to these diseases involving erythroid progenitor and precursor cells lead to production of fewer but larger red blood cells, and understanding these mechanisms can provide information for possible treatments.

Recent findings: Both inherited and acquired bone marrow diseases involving primarily impaired or delayed erythroid cell division or secondary adaptions to basic erythroid cellular deficits that results in prolonged cell division frequently present with macrocytic anemia.

Summary of findings: In marrow failure diseases, large accumulations of iron and heme in early stages of erythroid differentiation make cells in those stages especially susceptible to death, but the erythroid cells that can survive the early stages of terminal differentiation yield fewer but larger erythrocytes that are recognized clinically as macrocytic anemia. Other disorders that limit deoxynucleosides required for DNA synthesis affect a broader range of erythropoietic cells, but they also lead to macrocytic anemia. The source of macrocytosis in other diseases remains uncertain.

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来源期刊
CiteScore
6.60
自引率
3.10%
发文量
78
审稿时长
6-12 weeks
期刊介绍: ​​​​​​​​Current Opinion in Hematology is an easy-to-digest bimonthly journal covering the most interesting and important advances in the field of hematology. Its hand-picked selection of editors ensure the highest quality selection of unbiased review articles on themes from nine key subject areas, including myeloid biology, Vascular biology, hematopoiesis and erythroid system and its diseases.
期刊最新文献
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