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Myelodysplastische Syndrome

机译:骨髓增生异常综合征

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The myelodysplastic syndromes (MDS) are clonal disorders of hematopoietic stem cells. The transformation rate to acute myeloid leukemia reaches 30–40 %. In early phases of the disease, the clonal cells have a growth advantage but suffer from premature apoptosis, which explains the paradox of a cellular bone marrow coupled to peripheral blood cytopenias. At later stages, additional genetic aberrations accumulate and lead to proliferation with leukemic transformation. Patients with early MDS benefit from supportive therapy or growth factors. Sometimes, immunological or immunomodulatory treatments can suppress the malignant clone and strengthen normal hematopoiesis for sustained periods. Patients with advanced MDS are usually treated with cytotoxic therapy followed by allogeneic stem cell transplantation or with epigenetic therapy to initiate differentiation and slow down proliferation.
机译:骨髓增生异常综合症(MDS)是造血干细胞的克隆性疾病。急性髓细胞白血病的转化率达到30–40%。在疾病的早期阶段,克隆细胞具有生长优势,但会遭受过早的细胞凋亡,这解释了细胞骨髓与外周血细胞减少症相悖的悖论。在以后的阶段,更多的遗传畸变积累并导致白血病转化。患有早期MDS的患者可受益于支持疗法或生长因子。有时,免疫或免疫调节治疗可以抑制恶性克隆并在持续时间内增强正常的造血功能。患有晚期MDS的患者通常接受细胞毒性治疗,然后进行同种异体干细胞移植或表观遗传治疗,以启动分化并减缓增殖。

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