• BLOOD RESEARCH
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• v.53 no.4
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• pp.268-268
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• 2018

• Pediatric Gastroenterology, Hepatology & Nutrition
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• v.21 no.1
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• pp.68-71
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• 2018

Androgen therapy has proven efficacy in treating patients with bone marrow failure who are not candidates for bone marrow transplantation. Herein, we report on a case of colonic angioectasia secondary to oxymetholone use in an adolescent patient with Hoyeraal-Hreidarsson syndrome (HHS). A 13-year-old Caucasian male with HHS characterized by cerebellar hypoplasia, developmental delay, microcephaly, esophageal strictures and myelodysplasia presented with severe hematochezia from colonic angioectasia secondary to long-term oxymetholone therapy. These vascular lesions resolved spontaneously once this anabolic steroid was discontinued. While androgen therapy is often recommended for certain anemias and myelodysplastic syndromes, clinicians should be aware of the potential complication in developing these perceived uncommon colonic angioectasias. Moreover, pediatric gastroenterologists should familiarize themselves in identifying these vascular lesions by colonoscopy, especially among the high risk groups on long-term anabolic steroid therapy.

• The Korean journal of internal medicine
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• v.33 no.6
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• pp.1194-1202
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• 2018

Background/Aims: This study evaluated the role of hypomethylating agents (HMA) compared to best supportive care (BSC) for patients with high or very-high (H/VH) risk myelodysplastic syndrome (MDS) according to the Revised International Prognostic Scoring System. Methods: A total of 279 H/VH risk MDS patients registered in the Korean MDS Working Party database were retrospectively analyzed. Results: HMA therapy was administered to 205 patients (73.5%), including 31 patients (11.1%) who then received allogeneic hematopoietic cell transplantation (allo-HCT), while 74 patients (26.5%) received BSC or allo-HCT without HMA. The 3-year overall survival (OS) rates were $53.1%{\pm}10.7%$ for allo-HCT with HMA, $75%{\pm}21.7%$ for allo-HCT without HMA, $17.3%{\pm}3.6%$ for HMA, and $20.8%{\pm}6.9%$ for BSC groups (p < 0.001). In the multivariate analysis, only allo-HCT was related with favorable OS (hazard ratio [HR], 0.356; p = 0.002), while very poor cytogenetic risk (HR, 5.696; p = 0.042), age ${\geq}65years$ (HR, 1.578; p = 0.022), Eastern Cooperative Oncology Group performance status (ECOG PS) 2 to 4 (HR, 2.837; p < 0.001), and transformation to acute myeloid leukemia (AML) (HR, 1.901; p = 0.001) all had an adverse effect on OS. Conclusions: For the H/VH risk group, very poor cytogenetic risk, age ${\geq}65years$, ECOG PS 2 to 4, and AML transformation were poor prognostic factors. HMA showed no benefit in terms of OS when compared to BSC. Allo-HCT was the only factor predicting a favorable long-term outcome. The use of HMA therapy did not seem to have an adverse effect on the transplantation outcomes. However, the conclusion of this study should be carefully interpreted and proven by large scale research in the future.

• Journal of Life Science
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• v.32 no.6
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• pp.468-475
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• 2022

The functional distinction between stem and progenitor cells is well established in several tissues, particularly in the blood. There, hematopoietic stem cells preserve their self-renewal potential and reconstitution ability in the bone marrow niche. Bone marrow represents a unique setting in which to examine how stroma influences tissue function. It was the setting in which the experimental definition of a niche was first provided in mammalian stem cell biology and where clear evidence for non-cell-autonomous oncogenesis was first defined. The relationship between bone and blood is ancient as all animals since the divergence of fish that have bones and blood, make blood in their bones. This long coevolution engendered complex interrelationships, including the first proposed and first experimentally defined niche for stem cells in mammals. Multiple bone marrow stromal cell types serve as regulators of hematopoiesis, and the dysfunction of some causes myelodysplasia and leukemia. However, no comprehensive atlas of stromal subpopulations exists. Therefore, we think these data point to something of importance, such as how the needs and challenges of the organism become translated down to distinct cell types that critically govern specific functions within tissues and do so at the level of a single molecule. We think this will be of broad interest to those focusing on systems biology and the physiology of organisms, particularly those seeking a molecular basis for understanding cell and tissue behavior. We summarized the current and emerging concepts of hematopoietic stem cells and bone marrow niche.