去甲基化药物及免疫检查点抑制剂在MDS中的研究进展
Research Progress of Hypomethylating Agents and Immune Checkpoint Inhibitors in MDS
DOI: 10.12677/ACM.2022.1291219, PDF,   
作者: 刘舒慧*:青海大学研究生院,青海 西宁;耿 惠#:青海大学附属医院血液科,青海 西宁
关键词: 骨髓增生异常综合征去甲基化药物免疫检查点抑制剂治疗Myelodysplastic Syndrome Hypomethylating Agents Immune Checkpoint Inhibitors Treatment
摘要: 骨髓增生异常综合征(Myelodysplastic syndrome, MDS)是一种以无效造血为特征的高度异质性疾病,表现范围广泛,从惰性和无症状的细胞减少到急性髓系白血病(AML)。目前MDS的发病机制还尚未完全清楚,其唯一的治疗方法是异基因造血干细胞移植(allo-HSCT),然而,由于allo-HSCT具有很高的毒性风险,人们常常考虑替代治疗。去甲基化药物及免疫检查点抑制剂的研究及临床应用,为MDS发病机制的探索和临床治疗带来了新方向。故本文主要就这两类药物在MDS中的作用机制、分类及临床疗效等方面进行综述,加深对MDS发病机制及新时代药物的了解,为MDS的治疗提供临床参考价值。
Abstract: Myelodysplastic syndrome (MDS) is a highly heterogeneous disease characterized by ineffective hematopoiesis, with a wide range of manifestations ranging from indolent and asymptomatic cell depletion to acute myeloid leukemia (AML). At present, the pathogenesis of MDS is not fully under-stood. The only treatment for MDS is allogeneic hematopoietic stem cell transplantation (allo-HSCT). However, because of the high toxicity risk of allo-HSCT, alternative treatment is often considered. The research and clinical application of hypomethylating agents and immune checkpoint inhibitors have brought a new direction for the exploration of pathogenesis and clinical treatment of MDS. Therefore, this article mainly reviews the mechanism of action, classification and clinical efficacy of these two types of drugs in MDS, deepening the understanding of the pathogenesis of MDS and the new era of drugs, and providing reference value for the treatment of MDS.
文章引用:刘舒慧, 耿惠. 去甲基化药物及免疫检查点抑制剂在MDS中的研究进展[J]. 临床医学进展, 2022, 12(9): 8450-8454. https://doi.org/10.12677/ACM.2022.1291219

参考文献

[1] 杨成艳, 李静, 刘桂玲. 骨髓增生异常综合征中的表观遗传学变化及相关药物治疗的新进展[J]. 齐齐哈尔医学院学报, 2018, 39(10): 1173-1175.
[2] Ornstein, M.C. and Sekeres, M.A. (2012) Combination Strategies in Myelo-dysplastic Syndromes. International Journal of Hematology, 95, 26-33. [Google Scholar] [CrossRef] [PubMed]
[3] 庞艳彬, 吴萍, 化罗明, 杜欣, 王静. 骨髓增生异常综合征中分子遗传学异常的研究进展[J]. 中国实验血液学杂志, 2018, 26(4): 1248-1252.
[4] Liang, S.M., Zhou, X.J., Pan, H., et al. (2019) Prognostic Value of DNMT3A Mutations in Myelodysplastic Syndromes: A Meta-Analysis. Hematol-ogy (Amsterdam, Netherlands), 24, 613-622. [Google Scholar] [CrossRef] [PubMed]
[5] Bond, D.R., Lee, H.J. and Enjeti, A.K. (2020) Unravelling the Epigenome of Myelodysplastic Syndrome: Diagnosis, Prognosis, and Response to Therapy. Cancers, 12, Article No. 3128. [Google Scholar] [CrossRef] [PubMed]
[6] 丁雪, 刘杰, 王博. 骨髓增生异常综合征DNA甲基化研究进展[J]. 牡丹江医学院学报, 2019, 40(4): 107-109.
[7] 黄紫莹, 李莉娟, 郭红艳. 免疫检查点抑制剂在骨髓增生异常综合征中的研究进展[J]. 中国临床研究, 2020, 33(11): 1570-1573.
[8] Bewersdorf, J.P. and Zeidan, A.M. (2020) Randomized Trials with Checkpoint Inhibitors in Acute Myeloid Leukaemia and Myelodysplastic Syndromes: What Have We Learned So Far and Where Are We Heading? Best Practice & Research Clinical Haematology, 33, Arti-cle ID: 101222. [Google Scholar] [CrossRef] [PubMed]
[9] Chokr, N., Patel, R. and Wattamwar, K. (2018) The Rising Era of Immune Checkpoint Inhibitors in Myelodysplastic Syndromes. Advances in Hematology, 2018, Article ID: 2458679. [Google Scholar] [CrossRef] [PubMed]
[10] Morita, K., Kantarjian, H.M., Montalban, B.G., et al. (2020) A Phase II Study of Double Immune Checkpoint Inhibitor Blockade with Nivolumab and Ipilimumab with or without Azacitidine in Patients with Myelodysplastic Syndrome (MDS). Blood, 136, 7-9. [Google Scholar] [CrossRef
[11] 焦梦媛. 免疫检查点抑制剂联合去甲基化药物治疗急性髓系白血病及骨髓增生异常综合征有效性及安全性的Meta分析[D]: [硕士学位论文]. 石家庄: 河北医科大学, 2021.
[12] 张若曦, 韩冰. 免疫检查点抑制剂治疗骨髓增生异常综合征的研究进展[J]. 基础医学与临床, 2021, 41(8): 1210-1215.
[13] Boddu, P., Kantarjian, H., Garcia-Manero, G., et al. (2018) The Emerging Role of Immune Checkpoint Based Approaches in AML and MDS. Leukemia & Lymphoma, 59, 790-802. [Google Scholar] [CrossRef] [PubMed]
[14] Cheng, W.Y., Satija, A. and Cheung, H.C. (2021) Persis-tence to Hypomethylating Agents and Clinical and Economic Outcomes among Patients with Myelodysplastic Syndromes. Hematology (Amsterdam, Netherlands), 26, 261-270. [Google Scholar] [CrossRef] [PubMed]