当前 MDS 移植调节方案面临的挑战

IF 6.9 2区 医学 Q1 HEMATOLOGY Blood Reviews Pub Date : 2024-07-10 DOI:10.1016/j.blre.2024.101223
{"title":"当前 MDS 移植调节方案面临的挑战","authors":"","doi":"10.1016/j.blre.2024.101223","DOIUrl":null,"url":null,"abstract":"<div><p>Myelodysplastic syndrome (MDS) is a very heterogeneous clonal disorder. Patients with “higher-risk” MDS, defined by specific recurrent genetic abnormalities, have a poor prognosis because of a high risk of progression to secondary acute myeloid leukemia with low chemosensitivity. Allogeneic hematopoietic stem cell transplantation remains the only treatment that offers durable disease control because the donor immune system allows graft-versus-MDS effects. In terms of preparation steps before transplantation, targeting the malignant clone by increasing the conditioning regimen intensity is still a matter of intense debate. MDS is mainly diagnosed in older patients, and high toxicity related to common myeloablative conditioning regimens has been reported. Efforts to include new drugs in the conditioning regimen to achieve the best malignant clone control without increasing toxicity have been made over the past 20 years. We summarized these retrospective and prospective studies and evaluated the limitations of the available evidence to delineate the ideal conditioning regimen.</p></div>","PeriodicalId":56139,"journal":{"name":"Blood Reviews","volume":null,"pages":null},"PeriodicalIF":6.9000,"publicationDate":"2024-07-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0268960X24000560/pdfft?md5=b28710cbdba2c6aa48108ac802eca6b2&pid=1-s2.0-S0268960X24000560-main.pdf","citationCount":"0","resultStr":"{\"title\":\"Current challenges in conditioning regimens for MDS transplantation\",\"authors\":\"\",\"doi\":\"10.1016/j.blre.2024.101223\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div><p>Myelodysplastic syndrome (MDS) is a very heterogeneous clonal disorder. Patients with “higher-risk” MDS, defined by specific recurrent genetic abnormalities, have a poor prognosis because of a high risk of progression to secondary acute myeloid leukemia with low chemosensitivity. Allogeneic hematopoietic stem cell transplantation remains the only treatment that offers durable disease control because the donor immune system allows graft-versus-MDS effects. In terms of preparation steps before transplantation, targeting the malignant clone by increasing the conditioning regimen intensity is still a matter of intense debate. MDS is mainly diagnosed in older patients, and high toxicity related to common myeloablative conditioning regimens has been reported. Efforts to include new drugs in the conditioning regimen to achieve the best malignant clone control without increasing toxicity have been made over the past 20 years. We summarized these retrospective and prospective studies and evaluated the limitations of the available evidence to delineate the ideal conditioning regimen.</p></div>\",\"PeriodicalId\":56139,\"journal\":{\"name\":\"Blood Reviews\",\"volume\":null,\"pages\":null},\"PeriodicalIF\":6.9000,\"publicationDate\":\"2024-07-10\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.sciencedirect.com/science/article/pii/S0268960X24000560/pdfft?md5=b28710cbdba2c6aa48108ac802eca6b2&pid=1-s2.0-S0268960X24000560-main.pdf\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Blood Reviews\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://www.sciencedirect.com/science/article/pii/S0268960X24000560\",\"RegionNum\":2,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q1\",\"JCRName\":\"HEMATOLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Blood Reviews","FirstCategoryId":"3","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S0268960X24000560","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"HEMATOLOGY","Score":null,"Total":0}
引用次数: 0

摘要

骨髓增生异常综合征(MDS)是一种异质性很强的克隆性疾病。高危 "骨髓增生异常综合征(MDS)患者由特定的复发性遗传异常所定义,预后较差,因为很有可能发展为继发性急性髓细胞白血病,且化疗敏感性低。同种异体造血干细胞移植仍是唯一能持久控制疾病的治疗方法,因为供体免疫系统可产生移植物抗 MDS 效应。就移植前的准备步骤而言,通过增加调理方案的强度来靶向恶性克隆仍是一个激烈争论的问题。MDS 主要在年龄较大的患者中确诊,有报道称常见的髓质消融调理方案会产生高毒性。在过去的 20 年中,人们一直在努力将新药纳入调理方案,以在不增加毒性的情况下达到最佳的恶性克隆控制效果。我们总结了这些回顾性和前瞻性研究,并对现有证据的局限性进行了评估,以确定理想的调理方案。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
查看原文
分享 分享
微信好友 朋友圈 QQ好友 复制链接
本刊更多论文
Current challenges in conditioning regimens for MDS transplantation

Myelodysplastic syndrome (MDS) is a very heterogeneous clonal disorder. Patients with “higher-risk” MDS, defined by specific recurrent genetic abnormalities, have a poor prognosis because of a high risk of progression to secondary acute myeloid leukemia with low chemosensitivity. Allogeneic hematopoietic stem cell transplantation remains the only treatment that offers durable disease control because the donor immune system allows graft-versus-MDS effects. In terms of preparation steps before transplantation, targeting the malignant clone by increasing the conditioning regimen intensity is still a matter of intense debate. MDS is mainly diagnosed in older patients, and high toxicity related to common myeloablative conditioning regimens has been reported. Efforts to include new drugs in the conditioning regimen to achieve the best malignant clone control without increasing toxicity have been made over the past 20 years. We summarized these retrospective and prospective studies and evaluated the limitations of the available evidence to delineate the ideal conditioning regimen.

求助全文
通过发布文献求助,成功后即可免费获取论文全文。 去求助
来源期刊
Blood Reviews
Blood Reviews 医学-血液学
CiteScore
13.80
自引率
1.40%
发文量
78
期刊介绍: Blood Reviews, a highly regarded international journal, serves as a vital information hub, offering comprehensive evaluations of clinical practices and research insights from esteemed experts. Specially commissioned, peer-reviewed articles authored by leading researchers and practitioners ensure extensive global coverage across all sub-specialties of hematology.
期刊最新文献
From MGUS to multiple myeloma: Unraveling the unknown of precursor states. Advancing CAR T-cell therapies: Preclinical insights and clinical translation for hematological malignancies. Corrigendum to "Measurable residual disease (MRD)-testing in haematological cancers: A giant leap forward or sideways?"[BLOOD REVIEWS, 9 August 2024, https://doi.org/10.1016/j.blre.2024.101226]. Clinical applications of circulating tumor DNA in hematological malignancies: From past to the future Tailoring oral anticoagulant treatment in the era of multi-drug therapies for PAH and CTEPH.
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
现在去查看 取消
×
提示
确定
0
微信
客服QQ
Book学术公众号 扫码关注我们
反馈
×
意见反馈
请填写您的意见或建议
请填写您的手机或邮箱
已复制链接
已复制链接
快去分享给好友吧!
我知道了
×
扫码分享
扫码分享
Book学术官方微信
Book学术文献互助
Book学术文献互助群
群 号:481959085
Book学术
文献互助 智能选刊 最新文献 互助须知 联系我们:info@booksci.cn
Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。
Copyright © 2023 Book学术 All rights reserved.
ghs 京公网安备 11010802042870号 京ICP备2023020795号-1