The Rising Era of Immune Checkpoint Inhibitors in Myelodysplastic Syndromes.
The Rising Era of Immune Checkpoint Inhibitors in Myelodysplastic Syndromes.
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DOI：
10.1155/2018/2458679
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发表时间：
2018-01-01
影响因子：
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通讯作者：
Chokr, Samer
中科院分区：
文献类型：
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作者：
Chokr, Nora;Patel, Rima;Chokr, Samer
骨髓增生异常综合征(MDS)是一组以无效造血为特征的异质性疾病，其表现范围广泛，从惰性和无症状的红细胞减少症到急性髓系白血病(AML)。MDS是克隆细胞及其周围微环境中遗传和表观遗传紊乱的结果。研究表明，MDS与其他自身免疫性疾病之间存在关联。在MDS中已经发现了几种免疫机制，提示免疫失调可能至少部分参与了MDS的发病机制。这导致了对免疫调节药物作为潜在治疗选择的作用的严格调查。通过免疫检查点抑制进行表观遗传修饰，虽然已被公认为晚期实体瘤的一种治疗方法，但在包括高危MDS在内的血液系统恶性肿瘤中是一种正在考虑的新方法。一些试验正在研究这些药物在MDS中的疗效，作为一线治疗和复发，既作为单一治疗，也作为与其他药物联合使用。本文就免疫检查点抑制剂在MDS中的应用以及目前评价其疗效的研究进展作一综述。
Myelodysplastic syndromes (MDS) are a heterogeneous group of diseases characterized by ineffective hematopoiesis and a wide spectrum of manifestations ranging from indolent and asymptomatic cytopenias to acute myeloid leukemia (AML). MDS result from genetic and epigenetic derangements in clonal cells and their surrounding microenvironments. Studies have shown associations between MDS and other autoimmune diseases. Several immune mechanisms have been identified in MDS, suggesting that immune dysregulation might be at least partially implicated in its pathogenesis. This has led to rigorous investigations on the role of immunomodulatory drugs as potential treatment options. Epigenetic modification via immune check point inhibition, while well established as a treatment method for advanced solid tumors, is a new approach being considered in hematologic malignancies including high risk MDS. Several trials are looking at the efficacy of these agents in MDS, as frontline therapy and in relapse, both as monotherapy and in combination with other drugs. In this review, we explore the utility of immune checkpoint inhibitors in MDS and current research evaluating their efficacy.