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Disordered Immune Regulation and its Therapeutic Targeting in Myelodysplastic Syndromes

  • Myelodysplastic Syndromes (M Savona, Section Editor)
  • Published:
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Abstract

Purpose of Review

Immune dysregulation is a defining feature of myelodysplastic syndromes (MDS). Recently, several studies have further defined the complex role of immune alterations within MDS. Herein, we will summarize some of these findings and discuss the therapeutic strategies currently in development.

Recent Findings

Immune alterations in MDS are complex, heterogeneous, and intertwined with clonal hematopoiesis and stromal cell dysfunction. Inflammation in MDS proceeds as a vicious cycle, mediated in large part by secreted factors, which induce cell death and activate innate immune signaling. Therapeutic targeting of this variable immune dysregulation has led to modest responses thus far, but incorporation of the growing repertoire of immunotherapy brings new potential for improved outcomes.

Summary

The immune milieu is variable across the spectrum of MDS subtypes, with a changing balance of inflammatory and suppressive cellular forces from low- to high-risk disease.

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Authors and Affiliations

  1. Boston University School of Medicine, Boston, MA, USA

    Kathryn S. Ivy

  2. Department of Medicine, Vanderbilt University Medical Center, Nashville, TN, USA

    Kathryn S. Ivy & P. Brent Ferrell Jr

  3. Vanderbilt-Ingram Cancer Center, Vanderbilt University Medical Center, Nashville, TN, USA

    P. Brent Ferrell Jr

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Kathryn S. Ivy and P. Brent Ferrell, Jr. declare that they have no relevant conflicts of interest.

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This article is part of the Topical Collection on Myelodysplastic Syndromes

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Ivy, K.S., Brent Ferrell, P. Disordered Immune Regulation and its Therapeutic Targeting in Myelodysplastic Syndromes. Curr Hematol Malig Rep 13, 244–255 (2018). https://doi.org/10.1007/s11899-018-0463-9

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