骨髓增生异常综合征中的T细胞免疫

骨髓增生异常综合征(myelodysplastic syndromes,MDS)是一组肿瘤性疾病,以骨髓无效造血并向急性髓系白血病转化的风险为特点.流行病学显示自身免疫性疾病的患者发生MDS风险增加,为二者存在共同病因的假设提供了依据.MDS骨髓微环境中存在T细胞过度活化的现象.部分低危组MDS治疗药物具有抑制T细胞免疫机制,而高危组MDS的去甲基化药物则增强T细胞的抗肿瘤免疫反应,特别是免疫检查点抑制剂正在MDS中进行临床实验.因此,MDS中T细胞免疫失调的双重作用值得深思,充分认识T细胞免疫异常在M D S发病机制中的作用是形成新治疗方法的理论基础.

T-cell immunity in myelodysplastic syndrome

Myelodysplastic syndrome (MDS)is a heterogeneous group of myeloid neoplasms ,charac-terized by ineffective hematopoiesis and the increased risk of transformation to acute myeloid leukemia. Epidemi-cal data indicate that patients with autoimmune diseases show an increased risk of developing MDS. This sup-ports the hypotheses that autoimmune diseases and MDS share the common etiological mechanisms. Some pa-tients with Lower-risk MDS need immunosuppressive treatment to T cell immune reaction. However,the hypom-ethylating agents augment the antitumor immune activity of T cells. Immune checkpoint inhibitors that target the interactions of MDS clone with T cells are currently in clinical trial. Therefore,study on the dual effect of dys-function of T-cell immunity in MDS is challenging and important to develop new therapeutic strategies for MDS.