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Leukemia. 2015 Jul;29(7):1458-69. doi: 10.1038/leu.2015.69. Epub 2015 Mar 12.

Deregulation of innate immune and inflammatory signaling in myelodysplastic syndromes.

Author information

1
Department of Leukemia, The University of Texas MD Anderson Cancer Center, Houston, TX, USA.
2
1] Division of Experimental Hematology and Cancer Biology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA [2] Department of Cancer Biology, University of Cincinnati College of Medicine, Cincinnati, OH, USA.
3
1] Department of Leukemia, The University of Texas MD Anderson Cancer Center, Houston, TX, USA [2] Department of Hematology, University Hospital of Salamanca, Salamanca, Spain.
4
1] Division of Hematologic Malignancies, Department of Medicine (Oncology), Einstein/Montefiore Medical Center, New York, NY, USA [2] Albert Einstein Cancer Center and Ruth L. and David S. Gottesman Institute for Stem Cell and Regenerative Medicine Research, Albert Einstein College of Medicine, New York, NY, USA [3] Department of Developmental and Molecular Biology, Albert Einstein College of Medicine, New York, NY, USA.
5
1] Division of Hematologic Malignancies, Department of Medicine (Oncology), Einstein/Montefiore Medical Center, New York, NY, USA [2] Albert Einstein Cancer Center and Ruth L. and David S. Gottesman Institute for Stem Cell and Regenerative Medicine Research, Albert Einstein College of Medicine, New York, NY, USA [3] Department of Cell Biology, Albert Einstein College of Medicine, New York, NY, USA.

Abstract

Myelodysplastic syndromes (MDSs) are a group of heterogeneous clonal hematologic malignancies that are characterized by defective bone marrow (BM) hematopoiesis and by the occurrence of intramedullary apoptosis. During the past decade, the identification of key genetic and epigenetic alterations in patients has improved our understanding of the pathophysiology of this disease. However, the specific molecular mechanisms leading to the pathogenesis of MDS have largely remained obscure. Recently, essential evidence supporting the direct role of innate immune abnormalities in MDS has been obtained, including the identification of multiple key regulators that are overexpressed or constitutively activated in BM hematopoietic stem and progenitor cells. Mounting experimental results indicate that the dysregulation of these molecules leads to abnormal hematopoiesis, unbalanced cell death and proliferation in patients' BM, and has an important role in the pathogenesis of MDS. Furthermore, there is compelling evidence that the deregulation of innate immune and inflammatory signaling also affects other cells from the immune system and the BM microenvironment, which establish aberrant associations with hematopoietic precursors and contribute to the MDS phenotype. Therefore, the deregulation of innate immune and inflammatory signaling should be considered as one of the driving forces in the pathogenesis of MDS. In this article, we review and update the advances in this field, summarizing the results from the most recent studies and discussing their clinical implications.

PMID:
25761935
PMCID:
PMC4857136
DOI:
10.1038/leu.2015.69
[Indexed for MEDLINE]
Free PMC Article

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