较低危骨髓增生异常综合征患者的预后因素研究进展

Research Progress on Prognostic Factors in Patients with Lower-Risk Myelodysplastic Syndrome——Review

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克隆性疾病,临床上表现为外周血细胞的减少,具有高风险向急性髓系白血病转化的特点。MDS患者的预期生存期差异很大,准确的预后评估尤为重要。目前,MDS患者通常根据临床预后评分系统分为较高危组(HR-MDS)和较低危组(LR-MDS),但这些评分系统具有一定的局限性。LR-MDS患者占MDS患者的2/3,拥有较低的疾病进展风险和较好的预后,治疗上主要依赖红细胞生成刺激剂、免疫抑制剂和成分输血,但仍有部分LR-MDS患者预后较差,现有的预后评分系统尚不能对其进行精准预后评估。本文依据MDS的异质性,主要对现有评估依据以外的潜在影响疾病预后的因素进行综述,以期为LR-MDS患者的预后评估和治疗提供参考。

Objective:Myelodysplastic syndrome (MDS)is a group of heterogeneous clonal disorders originating from hematopoietic stem cells,characterized by hemocytopenia and a high risk of transformation to acute myeloid leukemia(AML).The expected survival time of MDS patients varies widely,and accurate prognostic assessment is particularly important.Currently,patients with MDS are usually classified into a higher-risk group(HR-MDS)and a lower-risk group(LR-MDS)based on clinical prognostic scoring systems,but these scoring systems have certain limitations.Patients with LR-MDS account for 2/3 of MDS patients,with a lower risk of disease progression and a better prognosis,and their treatment mainly relies on erythropoiesis-stimulating agents,immunosuppressants and component transfusion.However,some LR-MDS patients still have poor prognosis,and the existing prognostic scoring systems cannot accurately evaluate their prognosis.In this review,the potential factors that may influence the prognosis of MDS patients beyond the existing assessment criteria were briefly summarized,with the aim of providing reference for the prognosis evaluation and treatment of LR-MDS patients.