铁超载在骨髓增生异常综合征中的研究进展

Advances progress of iron overload in myelodysplastic syndrome

骨髓增生异常综合征(MDS)是以无效造血为特点的异质性克隆性疾病,红细胞输注是其支持治疗的重要组成部分,但长期输血会导致铁超载,产生活性氧(ROS),引起肝脏、心脏等多器官损害,同时,ROS的积累对造血干细胞也有不利影响,可能导致MDS进展,而有效的铁螯合治疗能改善血液学参数,减少并发症的发生,从而提高生存率。本文概述了关于MDS患者铁超载及其对造血系统影响的近期发现,并简要地讨论了螯合疗法在新发展背景下的地位。

Myelodysplastic syndrome(MDS) is a heterogeneous clonal disease characterized by ineffective hematopoiesis. Erythrocyte infusion is an important part of its supportive care. However, transfusion for a long term may lead to iron overload, produce reactive oxygen species(ROS), and cause damage to multiple organs such as the liver,heart and other organs. Meanwhile, ROS accumulation also has adverse effects on hematopoietic stem cells, which may lead to the development of MDS. Effective iron chelation therapy can improve hematological parameters, reduce the occurrence of complications, thus improve the survival rate. In this narrative review, we summarize recent findings regarding iron overload in MDS patients and their impacts on hematopoietic systems. We also briefly discuss the status of chelation therapy in the context of new developments.