一个系统的文献综述,关于在多发性骨髓瘤复发之前发生的克隆进化事件
Maja Zimmer Jakobsen1, Rasmus Froberg Brøndum2, Henrik Gregersen1
1Department of Hematology, Aalborg University Hospital, Aalborg, Denmark; Department of Clinical Medicine, Aalborg University, Aalborg, Denmark; Clinical Cancer Research Center, Aalborg University Hospital, Aalborg, Denmark.
Critical reviews in oncology/hematology
|November 16, 2024
概括
多发性骨髓瘤 (MM) 由于耐药性,仍然无法治愈. 本综述确定了导致复发性MM的克隆演变的遗传和非遗传因素,突出了了解瘤异质性的高分辨率方法的必要性.
科学领域:
- 血液学 血液学 血液学
- 癌症基因组学 癌症基因组学
- 进化生物学 进化生物学
背景情况:
- 多发性骨髓瘤 (MM) 是一种无法治愈的血液性恶性瘤.
- 治疗耐药性是管理MM的主要挑战,导致疾病复发.
- 了解克隆进化的机制对于克服抵抗至关重要.
研究的目的:
- 系统地审查和识别导致MM复发和药物耐药性的克隆进化决定因素.
- 描述导致复发性MM的瘤异质性的遗传和非遗传因素.
- 建议最佳方法来评估MM的克隆进化.
主要方法:
- 对复发MM的克隆进化论文进行系统的文献搜索.
- 选了631个非重复性出版物,其中28篇文章用于数据提取.
- 对遗传改变,突变特征,进化轨迹和非遗传决定因素的分析.
主要成果:
- 确定的主要主题包括遗传改变,突变特征,进化轨迹和非遗传决定因素.
- 诸如MAPK-Ras突变和染色体变化 (带1和17) 等因素推动了克隆多样化,增加了瘤突变负担.
- APOBEC活动和梅尔法兰治疗显著影响MM基因组的克隆组成.
结论:
- 克隆进化对多发性骨髓瘤的复发和耐药性有显著的贡献.
- 了解瘤异质性需要对遗传和非遗传因素进行全面分析.
- 建议结合高分辨率方法来准确评估MM的克隆进化.
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