CAJ | 학술논문

介绍第56届美国血液学会(ASH)年会关于骨髓增生异常综合征(MDS)和再生障碍性贫血(AA)患者进行异基因造血干细胞移植的时机选择的报道.同种异体造血干细胞移植(HSCT)治疗MDS是疾病治愈的有效途径,但病死率也很高.对于低危和中危-Ⅰ MDS患者,应尽量延后HSCT的应用时间.但是对中危-Ⅱ和高危MDS患者,在确诊后应尽快进行HSCT,其生存期明显优于延后HSCT的患者.HSCT前的预处理方案可以选择阿扎胞苷、白血病形式的诱导化疗或联合以上2种治疗.HSCT已被证实可以治愈重型AA,但新诊断的患者中HLA相合的同胞供者仅占1/4.总之,HLA匹配的相关和无关供者HSCT会成为大多数高危MDS和初发重型AA的治疗选择.
개소제56계미국혈액학회(ASH)년회관우골수증생이상종합정(MDS)화재생장애성빈혈(AA)환자진행이기인조혈간세포이식적시궤선택적보도.동충이체조혈간세포이식(HSCT)치료MDS시질병치유적유효도경,단병사솔야흔고.대우저위화중위-Ⅰ MDS환자,응진량연후HSCT적응용시간.단시대중위-Ⅱ화고위MDS환자,재학진후응진쾌진행HSCT,기생존기명현우우연후HSCT적환자.HSCT전적예처리방안가이선택아찰포감、백혈병형식적유도화료혹연합이상2충치료.HSCT이피증실가이치유중형AA,단신진단적환자중HLA상합적동포공자부점1/4.총지,HLA필배적상관화무관공자HSCT회성위대다수고위MDS화초발중형AA적치료선택.
New progresses of timing of allogeneic hematopoietic stem cell transplantation (allo-HSCT) for myelodysplastic syndrome (MDS) and aplastic anemia in the 56th ASH annual meetings were reviewed.Allo-HSCT for MDS was a potentially curative procedure,but it was associated with a significant risk of morbidity and mortality.With the recent approval of disease-modifying agents,the appropriate timing of alloHSCT needed to be addressed.For low and intermediate-1 IPSS risk groups,the decision to delay HSCT from the time of diagnosis maximized overall survival.For patients with intermediate-2 and high-risk disease,immediate HSCT at the time of diagnosis was associated with a greater number of life-years than HSCT at a delayed time point.The methods that underwent HSCT were after azacitidine,leukemia-type induction chemotherapy,or both.for severe aplastic anemia (SAA),HSCT was a proven cure,but HLA-matched sibling donors were found in fewer than 25 ％ of newly diagnosed patients.The use of early unrelated donor HSCT was an evolving concept that will became more accepted as improvements in HSCT outcomes continued.Moving forward,HLA-matched related and unrelated donor HSCT will likely become the treatment of choice for most patients with higher-risk MDS and newly diagnosed SAA.