前体血液病:诊断,风险分层,临床影响和管理
Yuxin Liu1, Pinkal Desai2, Omar Nadeem1
1Department of Medical Oncology, Dana-Farber Cancer Institute, Jerome Lipper Center for Multiple Myeloma Research, Harvard Medical School, Boston, MA.
概括
血液学前体状况如MGUS,MBL和CH是癌前的. 虽然它们很常见,并且随着年龄的增长而增加,但它们的低进展风险往往需要观察,风险分层指导管理.
科学领域:
- 血液学 血液学 血液学
- 在瘤学瘤学.
- 遗传学 是一个遗传学.
背景情况:
- 血液学前体状况,包括不确定的意义的单克隆性甘马病 (MGUS),单克隆B细胞淋巴细胞症 (MBL) 和克隆性血液形成 (CH),是癌前状态.
- 这些情况涉及血,淋巴细胞或骨髓细胞的克隆扩张,没有活跃的恶性瘤,通常通过例行实验室检测偶然检测到.
研究的目的:
- 审查血液学前体状况的特征,诊断,流行病学和管理.
- 强调风险分层对进展到明显的血液性恶性瘤的重要性.
主要方法:
- 审查现有的流行病学研究和MGUS,MBL和CH的诊断标准.
- 讨论当前的管理策略,强调对低风险病例的观察.
主要成果:
- 患病率随着年龄的增长而增加,MGUS影响3至4%的>50,MBL影响3至17%的成年人,CH影响10%的>50.
- 风险分层工具可用于评估进展风险,指导临床决策.
结论:
- 血液学前体状况是常见的,与年龄相关的先发性疾病.
- 由于进展率较低,观察是大多数患者的护理标准;风险分层是关键.
- 活跃的研究正在探索对高风险个体的早期干预.
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