The myelodysplastic syndromes: current approaches to therapy.
The myelodysplastic syndromes: current approaches to therapy.
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骨髓增生异常综合征：当前的治疗方法。
DOI：
10.7326/0003-4819-112-12-932
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发表时间：
1990
影响因子：
39.2
通讯作者：
B. Cheson
中科院分区：
文献类型：
--
作者：
B. Cheson
目的
回顾目前骨髓增生异常综合征患者的治疗选择。
数据识别
1968 年至 1989 年 9 月期间报告的研究是通过使用 MEDLINE 的计算机搜索以及对已识别文章的参考书目进行广泛搜索来确定的。
研究选择
所有文章、摘要和评论均经过评估，并且对包含治疗数据的文章、摘要和评论进行了反应率、生存率和毒性分析。
数据综合结果
骨髓增生异常综合征的治疗方法包括激素、化疗、骨髓移植和分化剂，包括造血生长因子。除骨髓移植外，没有一种方法可以治愈或提高生存率。造血生长因子引起了临床试验的兴趣，因为它们会增加骨髓增生异常综合征患者的中性粒细胞数量，有时还会增加血小板数量。尽管如此，造血生长因子并非没有毒性。最值得注意的是，它们与加速急性髓性白血病的风险有关，并且它们对生存的影响仍然未知。
结论
骨髓增生异常综合征的标准治疗是支持治疗。当疾病进展时，具有侵袭性组织学或其他低风险特征的患者应考虑进行侵袭性化疗（加或不加生长因子）或骨髓移植。具有良好预后特征的患者是生长因子或其他潜在分化剂治疗的候选者。精心设计和进行的临床试验结合相关的实验室科学对于开发更合理的治疗方法至关重要。
PURPOSE
To review the current therapeutic options for patients with the myelodysplastic syndromes.
DATA IDENTIFICATION
Studies reported between 1968 and September 1989 were identified through computer searches using MEDLINE and through extensive searching of bibliographies of identified articles.
STUDY SELECTION
All articles, abstracts, and reviews were evaluated, and those that contained therapeutic data were analyzed for response rates, survival, and toxicity.
RESULTS OF DATA SYNTHESIS
Therapies for the myelodysplastic syndromes have included hormones, chemotherapy, bone marrow transplantation, and differentiating agents, including hematopoietic growth factors. With the exception of bone marrow transplantation, none is curative or increases survival. Hematopoietic growth factors are of interest for clinical trials, because they increase the number of neutrophils and, occasionally, the number of platelets in patients with the myelodysplastic syndromes. Nonetheless, hematopoietic growth factors are not without toxicity; most notably, they are associated with a risk for acceleration to acute myeloid leukemia, and their effect on survival remains unknown.
CONCLUSIONS
Standard therapy for the myelodysplastic syndromes is supportive care. When the disease progresses, patients with aggressive histologic or other poor-risk features should be considered for aggressive chemotherapy, with or without growth factors, or bone marrow transplantation. Patients with good prognostic features are candidates for therapy with growth factors or other potential differentiating agents. Carefully designed and conducted clinical trials that incorporate correlative laboratory science are essential to developing a more rational approach to therapy.
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13-顺式视黄酸治疗骨髓增生异常综合征的 I-II 期研究。
DOI：
--
发表时间：
1985
期刊：
Cancer treatment reports
影响因子：
--
作者：
Greenberg,BR;Durie,BG;Barnett,TC;MeyskensJr,FL
通讯作者：
MeyskensJr,FL
1,25-二羟基维生素 D3：对人白血病前期和白血病细胞的体内和体外影响。
DOI：
--
发表时间：
1985
期刊：
Cancer treatment reports
影响因子：
--
作者：
Koeffler,HP;Hirji,K;Itri,L
通讯作者：
Itri,L
13-顺式视黄酸与安慰剂治疗骨髓增生异常性疾病的随机研究。
影响因子：
20.3
作者：
Koeffler,HP;Heitjan,D;Mertelsmann,R;Kolitz,JE;Schulman,P;Itri,L;Gunter,P;Besa,E
通讯作者：
Besa,E
骨髓增生异常综合征中造血前体细胞对 13-顺式视黄酸和 1,25 二羟基维生素 D3 的反应。
影响因子：
20.3
作者：
Swanson,G;Picozzi,V;Morgan,R;Hecht,F;Greenberg,P
通讯作者：
Greenberg,P
影响因子：
45.3
作者：
GAJEWSKI, JL;HO, WG;CHAMPLIN, RE
通讯作者：
CHAMPLIN, RE