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Updated: Apr 21, 2026
Use of Hematopoietic Stem Cell Transplantation to Assess the Origin of Myelodysplastic Syndrome
Published on: October 3, 2018
Myelodysplasia is in the niche: novel concepts and emerging therapies
E Bulycheva1, M Rauner2, H Medyouf3
1Medizinische Klinik und Poliklinik I, Universitätsklinikum Carl-Gustav-Carus, Technische Universität, Dresden, Germany.
Abstract:
Myelodysplastic syndromes (MDSs) represent clonal disorders mainly of the elderly that are characterized by ineffective hematopoiesis and an increased risk of transformation into acute myeloid leukemia. The pathogenesis of MDS is thought to evolve from accumulation and selection of specific genetic or epigenetic events. Emerging evidence indicates that MDS is not solely a hematopoietic disease but rather affects the entire bone marrow microenvironment, including bone metabolism. Many of these cells, in particular mesenchymal stem and progenitor cells (MSPCs) and osteoblasts, express a number of adhesion molecules and secreted factors that regulate blood regeneration throughout life by contributing to hematopoietic stem and progenitor cell (HSPC) maintenance, self-renewal and differentiation. Several endocrine factors, such as erythropoietin, parathyroid hormone and estrogens, as well as deranged iron metabolism modulate these processes. Thus, interactions between MSPC and HSPC contribute to the pathogenesis of MDS and associated pathologies. A detailed understanding of these mechanisms may help to define novel targets for diagnosis and possibly therapy. In this review, we will discuss the scientific rationale of 'osteohematology' as an emerging research field in MDS and outline clinical implications.
Insights
Myelodysplastic syndromes (MDSs) involve bone marrow issues beyond blood cells, affecting bone metabolism and mesenchymal stem cells. Understanding these interactions may reveal new diagnostic and therapeutic targets for MDS.
Area of Science:
- Hematology
- Bone Biology
- Stem Cell Biology
Background:
- Myelodysplastic syndromes (MDSs) are clonal hematopoietic stem cell disorders primarily affecting the elderly.
- MDS pathogenesis involves genetic/epigenetic events and impacts the bone marrow microenvironment, including bone metabolism.
- Mesenchymal stem and progenitor cells (MSPCs) and osteoblasts interact with hematopoietic stem and progenitor cells (HSPCs), influencing blood regeneration.
Purpose of the Study:
- To explore the concept of 'osteohematology' in the context of MDS.
- To review the interplay between bone marrow cells and hematopoietic stem cells in MDS pathogenesis.
- To discuss potential clinical implications and therapeutic targets arising from this understanding.
Main Methods:
- Review of existing scientific literature on MDS, bone metabolism, and cell interactions.
- Analysis of the role of mesenchymal stem and progenitor cells (MSPCs) and osteoblasts in MDS.
- Examination of endocrine factors and iron metabolism in modulating osteo-hematopoietic processes.
Main Results:
- MDS affects not only hematopoietic stem and progenitor cells (HSPCs) but also the bone marrow microenvironment.
- Interactions between MSPCs and HSPCs are implicated in MDS pathogenesis and associated conditions.
- Endocrine factors and iron metabolism play a role in modulating these critical cell interactions.
Conclusions:
- Osteohematology offers a novel framework for understanding MDS.
- Targeting the bone marrow microenvironment and cell-cell interactions presents potential therapeutic strategies for MDS.
- Further research into osteohematology could lead to improved diagnostics and treatments for MDS.
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