Факторы риска развития дифференцировочного синдрома у пациентов с острым промиелоцитарным лейкозом
https://doi.org/10.17650/1818-8346-2023-18-3-50-56
Аннотация
Дифференцировочный синдром (ДС) – тяжелое осложнение острого промиелоцитарного лейкоза и его лечения, являющееся одной из причин высокой ранней летальности. Схожесть клинических проявлений ДС и других осложнений, которые могут развиться на фоне терапии острого промиелоцитарного лейкоза, затрудняет диагностику ДС. При этом несвоевременное начало терапии ДС глюкокортикостероидными гормонами может привести к гибели пациента. Единственный принятый фактор риска развития ДС – инициальный лейкоцитоз. Специфические маркеры, подтверждающие ДС, на сегодняшний день пока не обнаружены. В ряде исследований показано, что у пациентов с диагностированным дС чаще обнаруживали экспрессию на опухолевых клетках CD56, CD54, CD2, CD15, CD13, маркеров незрелых гранулоцитов, β2-интегринов. Воздействие третиноина повышало экспрессию хемокиновых рецепторов, хемокинов и цитокинов опухолевыми клетками и эндотелием сосудов. Влияние, оказываемое биологическими особенностями атипичных промиелоцитов на систему свертывания, позволяет предположить наличие ассоциации состояния гемостаза с развитием ДС. Однако ценность перечисленных маркеров в качестве предикторов или признаков ДС еще нуждается в проверке, особенно когда речь идет о нехимиотерапевтическом лечении острого промиелоцитарного лейкоза триоксидом мышьяка.
При поддержке: Работа выполнена без спонсорской поддержки
Об авторах
А. А. Семенова
ФГБУ «Национальный медицинский исследовательский центр гематологии» Минздрава России
Россия
Россия
Арина Аркадьевна Семенова
125167
Новый Зыковский пр-д, 4
Москва
В. В. Троицкая
ФГБУ «Национальный медицинский исследовательский центр гематологии» Минздрава России
Россия
Россия
125167
Новый Зыковский пр-д, 4
Москва
И. В. Гальцева
ФГБУ «Национальный медицинский исследовательский центр гематологии» Минздрава России
Россия
Россия
125167
Новый Зыковский пр-д, 4
Москва
Е. Н. Паровичникова
ФГБУ «Национальный медицинский исследовательский центр гематологии» Минздрава России
Россия
Россия
125167
Новый Зыковский пр-д, 4
Москва
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Рецензия
Для цитирования:
Семенова А.А., Троицкая В.В., Гальцева И.В., Паровичникова Е.Н. Факторы риска развития дифференцировочного синдрома у пациентов с острым промиелоцитарным лейкозом. Онкогематология. 2023;18(3):50-56. https://doi.org/10.17650/1818-8346-2023-18-3-50-56
For citation:
Semenova A.A., Troitskaya V.V., Galtseva I.V., Parovichnikova E.N. Risk factors for a differentiation syndrome in patients with acute promyelocytic leukemia. Oncohematology. 2023;18(3):50-56. (In Russ.) https://doi.org/10.17650/1818-8346-2023-18-3-50-56
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