骨髓增生异常综合征最佳支持治疗的新进展

Advance on the best supportive therapy of myelodysplastic syndromes

骨髓增生异常综合征(MDS)是一组起源于造血干细胞的异质性髓系克隆性疾病,其治疗方案主要依据患者预后分级,以及综合考虑患者的年龄、一般状况评分、合并疾病指数评分和主观意愿等制定。最佳支持治疗是所有MDS患者的基础治疗,甚至对某些患者可能是唯一治疗选择。近年,随着地拉罗司、达依泊汀、转化生长因子(TGF)-β超级家族抑制剂、艾曲波帕、罗米斯汀等药物临床试验的完成和相继问世,MDS的最佳支持治疗方案较前更为优化。笔者通过去铁治疗,促红细胞生成素类制剂(ESA),TGF-β超级家族抑制剂、血小板生成素(TPO)受体激动剂等方面,对MDS最佳支持治疗的新进展进行阐述。

Myelodysplastic syndromes(MDS)are a group of heterogeneous myeloid clonal diseases originating from hematopoietic stem cells.Therapy decisions for MDS patients mainly based on the prognostic rating,age,general physical health,comorbidities and patients′intention.The best supportive therapy is the basic treatments of all MDS patients,sometimes even the only choice of several MDS patients.Recently,some new drugs such as deferasirox,darbepoetin,inhibitors of transforming growth factors(TGF)-βsuperfamily,eltrombopag and romiplostim provide better choices for MDS supportive therapy.This article reviews new research progress of the best supportive therapy for MDS in terms of iron elimination therapy,erythropoietin stimulating agents(ESA),TGF-βsuperfamily inhibitors,and thrombopoietin(TPO)receptor agonists.