急性粒细胞增多症自发性缓解的免疫学研究

Niakan Behzad
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摘要

提示急性髓性白血病,特别是发育不全的急性髓性白血病在G-CSF治疗后的自发缓解可能是由于G-CSF增强了急性炎症反应。这种急性炎症反应是一种发生在低计数的活化血小板和低血红蛋白。如果伴有急性炎症反应,那么用G-CSF治疗发育不全的急性髓系白血病更有可能导致缓解。皮下G-CSF给药和急性炎症反应之间的时间似乎对于获得最佳急性炎症反应和最佳先天免疫激活至关重要。白血病的自发缓解可能先于低血小板计数和贫血。低计数的活化血小板可能降低活化血小板对先天免疫和过继免疫的免疫抑制作用。贫血或低血红蛋白可导致无氧组织呼吸,随后发生乳酸酸中毒。乳酸酸中毒激活乳酸脱氢酶,从而使癌细胞功能失调。
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Proposed Immunology of the Spontaneous Remission of Acute Myleiod
It is suggested that the spontaneous remission of acute myeloid leukemia, particularly hypoplastic acute myeloid leukemia seen after G-CSF treatment is possibly due to G-CSF augmenting an acute inflammatory response. This acute inflammatory response is one occurring during a low count of activated platelets and a low hemoglobulin. It appears that hypoplastic acute myeloid leukemia treated with G-CSF would be more likely to result in a remission if accompanied by an acute inflammatory response. The timing between subcutaneous G-CSF administration and an acute inflammatory response seems to be crucial to obtain an optimum acute inflammatory response and the optimum activation of innate immunity. Spontaneous remission of leukemia may be preceded with a low platelet count and anemia. A low count of activated platelets may diminish the immunosuppressive effects of activated platelets on innate and adoptive immunity. Anemia or low hemoglobulin may result in anerobic tissue respiration followed by lactic acidosis. Lactic acidosis in activating the enzyme lactate dehydrogenase and thereby dysfunctional cancer cells.
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