再生障碍性贫血与淋巴细胞增殖性肿瘤间的关联

Relationship between aplastic anemia and lymphoproliferative neoplasm

目前趋同认为,再生障碍性贫血（AA）是T细胞介导的,以早期造血干祖细胞为靶目标的自身免疫疾病。早期观点和动物模型认为,病毒,尤以乙型、丙型肝炎病毒,EB病毒,以及一些药物、射线是可能是触发AA的因素。但越来越多的证据表明,有时AA以一种淋巴瘤副肿瘤现象而表现出来。

Aplastic anemia（AA）may precede,co-occur,or follow a lymphoproliferative neoplasm.The most common scenario is that of concurrent AA and T-cell large granular lymphocyte leukemia.Several cases of AA and concurrent small B-cell lymphomas/leukemia and Hodgkin lymphomas suggest another possible relationship between them and the approachable explanation might be that：anti-neoplastic immunological attempt to＇eradicate＇the underlying malignant clone then simultaneous or preceding AA.The＇immuno-deregulatory＇potential and the cytotoxicity of regimens used for lymphoma therapy might be able to trigger AA.Furthermore,some particular（immuno-）genetic patient backgrounds might be predisposing to both AA and lymphoid neoplasms or exposures to environmental factors,increasing the risk for both diseases.Finally,immunosuppression-or allogeneous hematopoietic stem cell transplantation-associated post-transplantational lymphoproliferative disorders in AA patients,who are treated in the respective manner is another relationship between them.As all above,scenarios are differently therapeutically accompanied by diverse outcomes.This review summarizes the potential associations between AA and lymphoproliferative neoplasms.