• BLOOD RESEARCH
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• 제53권4호
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• pp.268-268
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• 2018

• Pediatric Gastroenterology, Hepatology & Nutrition
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• 제21권1호
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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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• 제33권6호
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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.

• 생명과학회지
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• 제32권6호
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• pp.468-475
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• 2022

줄기세포와 전구세포 사이의 기능 분석은 여러 조직 특히 혈액에서 잘 확립되어 있다. 특히 조혈줄기세포는 골수 니쉬에서 자가재생능 및 재구성능을 가지고 있으며, 골수 내 기질세포는 조직 기능 조절에 큰 영향을 미친다. 최근 연구에서는 포유동물 줄기세포의 기능은 니쉬 세포 내에서 실험적으로 처음 증명되었고, 특히 미세환경에 의해 종양발생이 가능하다는 증거를 나타내고 있다. 고대에서부터 뼈와 피의 관계는 생체 내 필수불가결인 관계로 진화 과정을 거쳐 포유류의 줄기세포에 대해 최초로 제안되었고, 실험적으로 증명된 니쉬세포를 포함한 미세환경과의 복잡한 상호 관계를 규명하였다. 여러 골수 기질세포는 조혈줄기세포의 기능 조절을 하며, 일부의 기능장애는 골수 이형성 및 백혈병을 유발할 수 있다. 현재까지 여러 기질세포에 대한 맵핑이 되지 않아 현재 많은 연구자들이 단일 분자 수준에서 개개의 기질세포 유형을 파악하는 데이터가 필요하다고 주장하고 있으며 이를 바탕으로 골수 내 조혈줄기세포의 특정 기능을 파악할 수 있다고 볼 수 있다. 따라서 본 총설을 통해 조혈줄기세포 및 미세환경에 대한 이전 연구들의 흥미로운 문제를 논의하고, 조혈줄기세포와 골수 니쉬에 대한 현재 및 새로운 개념을 요약하고자 한다.