Blood:端粒长度对造血干细胞移植患者预后的影响

2020-08-28 MedSci原创 MedSci原创

造血干细胞移植是MDS患者的唯一治愈方法,但长期存活情况受到移植相关并发症风险的限制。端粒长度短,由遗传或获得性因素介导,削弱了细胞对遗传毒性和复制性应激的反应,并可鉴定出移植后具有较高毒性风险的患者

同种异体造血干细胞移植是骨髓增生异常综合症(MDS)患者的唯一潜在治愈方法,但长期存活情况受到移植相关并发症风险的限制。端粒长度短,由遗传或获得性因素介导,削弱了细胞对遗传毒性和复制性应激的反应,并可以鉴定出移植后具有较高毒性风险的患者。

Lindsley等检测了1514名MDS患者在移植前血液样本中的相对端粒长度,并评估了端粒长度与MDS疾病特征和移植预后的相关性。

研究结果显示,端粒长度短与患者年龄大、男性、影响DNA损伤修复的体细胞突变和移植前重度血细胞减少显著相关,但与骨髓母细胞计数、MDS治疗史或既往癌症治疗史无明显相关性。

(C:端粒长短与患者总体存活时间的关系;D:端粒长短与患者非复发死亡率的关系)

在≥40岁的1267例患者中,最短四分位数的端粒长度与较差的生存期相关,这是因为存在较高的非复发性死亡(NRM)风险(经重要的临床和遗传变量校正后)。端粒短对NRM的不良影响与移植患者的并发症无关,而且在接受强化化疗的患者中有选择的发生,包括清髓疗法和高剂量美法仑的低强度疗法。端粒短对NRM的影响在发生重度急性移植物抗宿主病的患者中最明显,提示短端粒长度可能会限制急性损伤后粘膜组织的再生潜能。

综上所述,端粒长度较短的MDS患者,可能会因为毒性过大而导致存活预后较差,可考虑采取旨在最大程度降低移植物毒性作用的策略。

原始出处:

R. Coleman Lindsley,et al. Short Telomere Length Predicts Non-Relapse Mortality after Stem Cell Transplantation for Myelodysplastic Syndrome. Blood. August 17,2020.

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    2020-08-31 独孤立克

    干细胞是热点,但是进入临床仍然需要时间和临床疗效验证哦

    0

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  5. [GetPortalCommentsPageByObjectIdResponse(id=1692151, encodeId=168e16921517e, content=<a href='/topic/show?id=a450530853c' target=_blank style='color:#2F92EE;'>#患者预后#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=26, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=53085, encryptionId=a450530853c, topicName=患者预后)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=8f4729287700, createdName=bnurmamat, createdTime=Wed Sep 23 05:30:16 CST 2020, time=2020-09-23, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1658942, encodeId=928f16589424b, content=<a href='/topic/show?id=c40ce798412' target=_blank style='color:#2F92EE;'>#细胞移植#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=24, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=77984, encryptionId=c40ce798412, topicName=细胞移植)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=ad4724938298, createdName=limedical1982, createdTime=Sat Oct 17 17:30:16 CST 2020, time=2020-10-17, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1025494, encodeId=7a0a10254940e, content=干细胞是热点,但是进入临床仍然需要时间和临床疗效验证哦, beContent=null, objectType=article, channel=null, level=null, likeNumber=42, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=独孤立克, createdTime=Mon Aug 31 14:30:16 CST 2020, time=2020-08-31, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1271524, encodeId=fb6812e152411, content=<a href='/topic/show?id=a0ff950018f' target=_blank style='color:#2F92EE;'>#造血干细胞#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=32, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=95001, encryptionId=a0ff950018f, topicName=造血干细胞)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=e729101, createdName=huanbaofeng, createdTime=Sun Aug 30 05:30:16 CST 2020, time=2020-08-30, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1288646, encodeId=f147128864609, content=<a href='/topic/show?id=8d20e5696c5' target=_blank style='color:#2F92EE;'>#端粒长度#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=51, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=75696, encryptionId=8d20e5696c5, topicName=端粒长度)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=8fc0211, createdName=doctor-chen9582, createdTime=Sun Aug 30 05:30:16 CST 2020, time=2020-08-30, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1494748, encodeId=643d1494e483d, content=<a href='/topic/show?id=084d9499599' target=_blank style='color:#2F92EE;'>#造血#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=23, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=94995, encryptionId=084d9499599, topicName=造血)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=caed9138962, createdName=俅侠, createdTime=Sun Aug 30 05:30:16 CST 2020, time=2020-08-30, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=880507, encodeId=147788050e2c, content=学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=78, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20210725/69b5882b3c3845c19efa131b4ff8b1f7/06ccd8f1857e4e14862049ab235618eb.jpg, createdBy=74c72110107, createdName=qinqiyun, createdTime=Fri Aug 28 23:59:39 CST 2020, time=2020-08-28, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=814776, encodeId=9dbe814e762e, content=学习了!, beContent=null, objectType=article, channel=null, level=null, likeNumber=79, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=8f435296195, createdName=ms3000000449926787, createdTime=Fri Aug 28 19:17:23 CST 2020, time=2020-08-28, status=1, ipAttribution=)]
  6. [GetPortalCommentsPageByObjectIdResponse(id=1692151, encodeId=168e16921517e, content=<a href='/topic/show?id=a450530853c' target=_blank style='color:#2F92EE;'>#患者预后#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=26, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=53085, encryptionId=a450530853c, topicName=患者预后)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=8f4729287700, createdName=bnurmamat, createdTime=Wed Sep 23 05:30:16 CST 2020, time=2020-09-23, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1658942, encodeId=928f16589424b, content=<a href='/topic/show?id=c40ce798412' target=_blank style='color:#2F92EE;'>#细胞移植#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=24, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=77984, encryptionId=c40ce798412, topicName=细胞移植)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=ad4724938298, createdName=limedical1982, createdTime=Sat Oct 17 17:30:16 CST 2020, time=2020-10-17, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1025494, encodeId=7a0a10254940e, content=干细胞是热点,但是进入临床仍然需要时间和临床疗效验证哦, beContent=null, objectType=article, channel=null, level=null, likeNumber=42, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=独孤立克, createdTime=Mon Aug 31 14:30:16 CST 2020, time=2020-08-31, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1271524, encodeId=fb6812e152411, content=<a href='/topic/show?id=a0ff950018f' target=_blank style='color:#2F92EE;'>#造血干细胞#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=32, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=95001, encryptionId=a0ff950018f, topicName=造血干细胞)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=e729101, createdName=huanbaofeng, createdTime=Sun Aug 30 05:30:16 CST 2020, time=2020-08-30, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1288646, encodeId=f147128864609, content=<a href='/topic/show?id=8d20e5696c5' target=_blank style='color:#2F92EE;'>#端粒长度#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=51, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=75696, encryptionId=8d20e5696c5, topicName=端粒长度)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=8fc0211, createdName=doctor-chen9582, createdTime=Sun Aug 30 05:30:16 CST 2020, time=2020-08-30, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1494748, encodeId=643d1494e483d, content=<a href='/topic/show?id=084d9499599' target=_blank style='color:#2F92EE;'>#造血#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=23, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=94995, encryptionId=084d9499599, topicName=造血)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=caed9138962, createdName=俅侠, createdTime=Sun Aug 30 05:30:16 CST 2020, time=2020-08-30, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=880507, encodeId=147788050e2c, content=学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=78, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20210725/69b5882b3c3845c19efa131b4ff8b1f7/06ccd8f1857e4e14862049ab235618eb.jpg, createdBy=74c72110107, createdName=qinqiyun, createdTime=Fri Aug 28 23:59:39 CST 2020, time=2020-08-28, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=814776, encodeId=9dbe814e762e, content=学习了!, beContent=null, objectType=article, channel=null, level=null, likeNumber=79, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=8f435296195, createdName=ms3000000449926787, createdTime=Fri Aug 28 19:17:23 CST 2020, time=2020-08-28, status=1, ipAttribution=)]
    2020-08-30 俅侠
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    2020-08-28 qinqiyun

    学习了

    0

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    2020-08-28 ms3000000449926787

    学习了!

    0

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