Reframing thalassaemia syndrome as a benign haematopoietic stem cell disorder.

Autor: Maggio A; Campus of Haematology Franco and Piera Cutino, AOOR Villa Sofia-V. Cervello, Palermo, Italy., Napolitano M; Campus of Haematology Franco and Piera Cutino, AOOR Villa Sofia-V. Cervello, Palermo, Italy.; Dipartimento PROMISE, Università degli Studi di AOUP 'P. Giaccone', Palermo, Italy., Taher AT; Division of Hematology and Oncology, Internal Medicine, American University of Beirut Medical Center, Beirut, Lebanon., Bou-Fakhredin R; Division of Clinical Sciences and Community Health, University of Milan, Milan, Italy., Ostuni MA; Université Paris Citè Diderot 6 Rue Alexandre Cabanel Paris, Paris, France.
Jazyk: angličtina
Zdroj: British journal of haematology [Br J Haematol] 2024 Dec 15. Date of Electronic Publication: 2024 Dec 15.
DOI: 10.1111/bjh.19919
Abstrakt: Thalassaemia, caused by over 250 mutations in the beta globin gene, changes the haematopoietic stem cell (HSC) differentiation, leading to ineffective erythropoiesis. This Wider Perspective article overlooks its underlying nature as a benign HSC disorder with a significant impact on the erythroid cell lineage. The simplicity of managing symptoms through transfusions and iron chelation therapy has shifted the focus away from the development of cell-based treatments. The identification of the beta039 mutation by Chang and Kan in 1979 marked a turning point, suggesting as main approach the molecular level by correcting the beta globin chain imbalances through gene insertion and editing. However, challenges of technology have delayed the implementation of these strategies for over four decades. In contrast, the past two decades have witnessed significant advances in the treatment of HSC disorders of the myeloid clone which are driven by a 'target cell strategy'. Many current and innovative treatments for thalassaemia are now adopting this approach, highlighting the importance of identifying suitable candidates through risk stratification. This manuscript explores the evolving understanding of thalassaemia syndromes as congenital HSC disorders of the erythroid clone and examines the implications of this perspective for the development of future treatments.
(© 2024 British Society for Haematology and John Wiley & Sons Ltd.)
Databáze: MEDLINE
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