从病理生理学到管理策略全面回顾肥大细胞增多症

Magdalena Marchaj, Bartosz Basiaga, Klaudia Żądecka-Kobiałka, Anna Putra, Karolina Bednarz, Monika Nowicka-Jasińska, Paweł Frączyk, Sara Bieniek-Zając, Sebastian Baczkowski, Klaudia Krawiec
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摘要

引言肥大细胞增多症是一种罕见的血液肿瘤,其特征是肥大细胞在各种组织中异常增殖和聚集。其临床表现千差万别,既有皮肤病变,也有可能危及生命的全身受累症状。了解肥大细胞增多症的病理生理学、诊断和治疗对改善患者预后至关重要。 研究目的:本研究旨在全面概述肥大细胞增多症,包括其流行病学、风险因素、病理生理学、临床表现、诊断方法和管理策略。本研究旨在通过综合当前有关肥大细胞增多症的知识,加深对该疾病的了解并指导临床实践。 知识现状描述:肥大细胞增多症分为皮肤型和全身型,并根据临床和组织病理学特征分为多种亚型。诊断需要结合临床怀疑、血清胰蛋白酶水平、骨髓活检组织学检查和基因检测。治疗策略包括对症治疗、避免诱发因素以及单克隆抗体和酪氨酸激酶抑制剂等靶向疗法。晚期患者可能需要细胞再生疗法或异体造血干细胞移植(alloHSCT)。 结论:尽管在诊断和治疗方面取得了进展,但实现肥大细胞增多症的持久缓解仍具有挑战性,尤其是在晚期病例中。需要进一步研究该疾病的分子机制,并开发新型治疗方法,以改善患者的预后和生活质量。
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Comprehensive Review of Mastocytosis From Pathophysiology to Management Strategies
Introduction: Mastocytosis is a rare hematologic neoplasm characterized by the abnormal proliferation and accumulation of mast cells in various tissues. Its clinical manifestations vary widely, ranging from cutaneous lesions to systemic involvement with potentially life-threatening symptoms. Understanding the pathophysiology, diagnosis, and management of mastocytosis is crucial for improving patient outcomes.    Aim of the Study: The aim of this study was to provide a comprehensive overview of mastocytosis, including its epidemiology, risk factors, pathophysiology, clinical manifestations, diagnostic approaches, and management strategies. By synthesizing current knowledge on mastocytosis, this study aims to enhance understanding of the disease and guide clinical practice.    Description of the State of Knowledge: Mastocytosis is classified into cutaneous and systemic forms, with various subtypes based on clinical and histopathological features. Diagnosis relies on a combination of clinical suspicion, serum tryptase levels, histological examination of bone marrow biopsies, and genetic testing. Management strategies include symptomatic treatment, avoidance of triggers, and targeted therapies such as monoclonal antibodies and tyrosine kinase inhibitors. Advanced forms may require cytoreductive therapy or allogeneic hematopoietic stem cell transplantation (alloHSCT).    Conclusions: Despite advancements in diagnosis and treatment, achieving lasting remission in mastocytosis remains challenging, especially in advanced cases. Further research into the molecular mechanisms underlying the disease and the development of novel therapeutic modalities are needed to improve patient outcomes and quality of life.
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