|
抗肿瘤治疗所致骨髓抑制的研究与进展
|
Abstract:
随着人类对肿瘤不断的攻克,化疗药物,免疫检查点抑制剂和靶向药物在治疗恶性肿瘤方面取得巨大进展,抗肿瘤药物所诱发的副作用主要有骨髓抑制、口腔炎、粘膜炎、腹泻和呕吐。其中,骨髓抑制是抗肿瘤治疗过程中最可能产生严重后果的副反应。本文将综述抗肿瘤治疗所致骨髓抑制的研究进展,明确抗肿瘤治疗后所致的骨髓抑制的病理变化,为治疗骨髓抑制的药物研发指出方向,为临床上对骨髓抑制预防性手段提供理论依据。
As humans continue to make strides in conquering tumors, significant progress has been made in the treatment of malignant tumors with chemotherapy drugs, immune checkpoint inhibitors, and targeted therapies. The side effects induced by anti-tumor drugs mainly include bone marrow suppression, oral mucositis, mucositis, diarrhea, and vomiting. Among them, bone marrow suppression is the most likely side effect to produce serious consequences during anti-tumor treatment. This article will review the research progress on bone marrow suppression induced by anti-tumor therapy, clarify the pathological changes of bone marrow suppression caused by anti-tumor treatment, point out directions for drug development to treat bone marrow suppression, and provide theoretical basis for preventive measures against bone marrow suppression in clinical practice.
[1] | Sung, H., Ferlay, J., Siegel, R.L., Laversanne, M., Soerjomataram, I., Jemal, A. and Bray, F. (2021) Global Cancer Sta-tistics 2020: GLOBOCAN Estimates of Incidence and Mortality Worldwide for 36 Cancers in 185 Countries. CA: A Cancer Journal for Clinicians, 71, 209-249. https://doi.org/10.3322/caac.21660 |
[2] | 中国临床肿瘤学会(CSCO)中西医结合专家委员会. 抗肿瘤药物引起骨髓抑制中西医结合诊治专家共识[J]. 临床肿瘤学杂志, 2021, 26(11): 1020-1027. |
[3] | 中国抗癌协会肿瘤临床化疗专业委员会, 中国抗癌协会肿瘤支持治疗专业委员会. 中国肿瘤药物相关血小板减少诊疗专家共识(2023版) [J]. 中华医学杂志, 2023, 103(33): 2579-2590. |
[4] | Xiao, H., Xiong, L., Song, X., Jin, P., Chen, L., Chen, X., Yao, H., Wang, Y. and Wang, L. (2017) Angelica Sinensis Polysaccharides Ameliorate Stress-Induced Premature Senescence of Hematopoietic Cell via Protecting Bone Marrow Stromal Cells from Oxidative Injuries Caused by 5-Fluorouracil. International Journal of Molecular Sciences, 18, Article 2265. https://doi.org/10.3390/ijms18112265. |
[5] | 于姣姣, 王杰, 陈超. 化疗引起骨髓抑制的机制及中医药防治的研究进展[J]. 中国医药导报, 2023, 20(22): 47-50. https://doi.org/10.20047/j.issn1673-7210.2023.22.10 |
[6] | Li, Y., Xue, Z., Dong, X., Liu, Q., Liu, Z., Li, H., Xing, H., Xu, Y., Tang, K., Tian, Z., Wang, M., Rao, Q. and Wang, J. (2020) Mitochondrial Dysfunction and Oxidative Stress in Bone Marrow Stromal Cells Induced by Daunorubicin Leads to DNA Damage in Hematopoietic Cells. Free Radical Biology and Medicine, 146, 211-221. https://doi.org/10.1016/j.freeradbiomed.2019.11.007 |
[7] | Henry, E., Souissi-Sahraoui, I., Deynoux, M., Lefèvre, A., Barroca, V., Campalans, A., Ménard, V., Calvo, J., Pflumio, F. and Arcangeli, M. (2019) Human Hematopoietic Stem/Progenitor Cells Display Reactive Oxygen Species-Dependent Long-Term Hematopoietic Defects after Exposure to Low Doses of Ionizing Radiations. Haematologica, 105, 2044-2055. https://doi.org/10.3324/haematol.2019.226936 |
[8] | Gill, J.G., Piskounova, E. and Morrison, S.J. (2016) Cancer, Oxidative Stress, and Metastasis. Cold Spring Harbor Symposia on Quantitative Biology, 81, 163-175. https://doi.org/10.1101/sqb.2016.81.030791 |
[9] | Liu, M., Tan, H., Zhang, X., Liu, Z., Cheng, Y., Wang, D. and Wang, F. (2014) Hematopoietic Effects and Mechanisms of Fufang E’jiao Jiang on Radiotherapy and Chemotherapy-Induced Myelosuppressed Mice. Journal of Ethnopharmacology, 152, 575-584. https://doi.org/10.1016/j.jep.2014.02.012 |
[10] | Xu, Y., Zeng, F., Jiang, J., Huo, J., Zhao, C., Yan, Z. and Li, L. (2022) The Hematopoietic Function of Medicinal Wine Maoji Jiu Revealed in Blood Deficiency Model Rats. Evidence-Based Complementary and Alternative Medicine, 2022, Article ID: 1025504. https://doi.org/10.1155/2022/1025504 |
[11] | Maryanovich, M., Zahalka, A.H., Pierce, H., Pinho, S., Nakahara, F., Asada, N., Wei, Q., Wang, X., Ciero, P., Xu, J., Leftin, A. and Frenette, P.S. (2018) Adrenergic Nerve Degeneration in Bone Marrow Drives Aging of the Hematopoietic Stem Cell Niche. Nature Medicine, 24, 782-791. https://doi.org/10.1038/s41591-018-0030-x |
[12] | Hsu, Y., Chen, L., Liu, Y., Chu, S., Chen, T., Tsai, K., Shen, M. and Liu, W. (2023) Electrical Sympathetic Neuromodulation Protects Bone Marrow Niche and Drives Hematopoietic Regeneration during Chemotherapy. Small Methods, 7, Article ID: 2201300. https://doi.org/10.1002/smtd.202201300 |
[13] | Park, M.H., Jung, I.K., Min, W., Choi, J.H., Kim, G.M., Jin, H.K. and Bae, J. (2017) Neuropeptide Y Improves Cisplatin-Induced Bone Marrow Dysfunction Without Blocking Chemotherapeutic Efficacy in a Cancer Mouse Model. BMB Reports, 50, 417-422. https://doi.org/10.5483/bmbrep.2017.50.8.099 |
[14] | Martínez-Zamudio, R.I., Robinson, L., Roux, P. and Bischof, O. (2017) SnapShot: Cellular Senescence Pathways. Cell, 170, 816-816.e1. https://doi.org/10.1016/j.cell.2017.07.049 |
[15] | Zhou, X., Yao, Z., Bai, H., Duan, J., Wang, Z., Wang, X., Zhang, X., Xu, J., Fei, K., Zhang, Z., Tan, F., Xue, Q., Gao, S., Gao, Y., Wang, J. and He, J. (2021) Treatment-Related Adverse Events of PD-1 and PD-L1 Inhibitor-Based Combination Therapies in Clinical Trials: A Systematic Review and Meta-Analysis. The Lancet Oncology, 22, 1265-1274. https://doi.org/10.1016/s1470-2045(21)00333-8 |
[16] | 中国抗癌协会肿瘤临床化疗专业委员会, 中国抗癌协会肿瘤支持治疗专业委员会. 中国肿瘤相关贫血诊治专家共识(2023版) [J]. 中华肿瘤杂志, 2023, 45(12): 1032-1040. |
[17] | Schwartz, R.N. (2007) Anemia in Patients with Cancer: Incidence, Causes, Impact, Management, and Use of Treatment Guidelines and Protocols. American Journal of Health-System Pharmacy, 64, S5-S13. https://doi.org/10.2146/ajhp060601 |
[18] | Thomaidis, T., Weinmann, A., Sprinzl, M., Kanzler, S., Raedle, J., Ebert, M., Schimanski, C.C., Galle, P.R., Hoehler, T. and Moehler, M. (2013) Erythropoietin Treatment in Chemotherapy-Induced Anemia in Previously Untreated Advanced Esophagogastric Cancer Patients. International Journal of Clinical Oncology, 19, 288-296. https://doi.org/10.1007/s10147-013-0544-7 |
[19] | Weycker, D., Bensink, M., Lonshteyn, A., Doroff, R. and Chandler, D. (2019) Use of Colony-Stimulating Factor Primary Prophylaxis and Incidence of Febrile Neutropenia from 2010 to 2016: A Longitudinal Assessment. Current Medical Research and Opinion, 35, 1073-1080. https://doi.org/10.1080/03007995.2018.1558851 |
[20] | 中国抗癌协会肿瘤临床化疗专业委员会, 中国抗癌协会肿瘤支持治疗专业委员会. 肿瘤化疗导致的中性粒细胞减少诊治中国专家共识(2023版) [J]. 中华肿瘤杂志, 2023, 45(7): 575-583. |
[21] | ten Berg, M.J., van den Bemt, P.M.L.A., Shantakumar, S., Bennett, D., Voest, E.E., Huisman, A., van Solinge, W.W. and Egberts, T.C.G. (2011) Thrombocytopenia in Adult Cancer Patients Receiving Cytotoxic Chemotherapy. Drug Safety, 34, 1151-1160. https://doi.org/10.2165/11594310-000000000-00000 |
[22] | 侯明, 李曼, 靳征. 重组人血小板生成素注射液上市后不良反应监测研究[J]. 中国新药与临床杂志, 2015, 34(8): 642-646. https://doi.org/10.14109/j.cnki.xyylc.2015.08.018 |
[23] | Lai, A.Y., Sorrentino, J.A., Dragnev, K.H., Weiss, J.M., Owonikoko, T.K., Rytlewski, J.A., Hood, J., Yang, Z., Malik, R.K., Strum, J.C. and Roberts, P.J. (2020) CDK4/6 Inhibition Enhances Antitumor Efficacy of Chemotherapy and Immune Checkpoint Inhibitor Combinations in Preclinical Models and Enhances T-Cell Activation in Patients with SCLC Receiving Chemotherapy. Journal for ImmunoTherapy of Cancer, 8, e000847. https://doi.org/10.1136/jitc-2020-000847 |