азануклеозиды

Гипометилирующие препараты в онкогематологии

ОБЗОРЫ , , , , , ,

А.Д. Ширин, О.Ю. Баранова

ФГБУ «Российский онкологический научный центр им. Н.Н. Блохина» Минздрава России, Каширское ш., д. 24, Москва, Российская Федерация, 115478

Для переписки: Антон Дмитриевич Ширин, канд. мед. наук, Каширское ш., д. 24, Москва, Российская Федерация, 115478; тел.: +7(499)324-28-24; e-mail: shirin-anton@mail.ru

Для цитирования: Ширин А.Д., Баранова О.Ю. Гипометилирующие препараты в онкогематологии. Клиническая онкогематология. 2016;9(4):369–82.

DOI: 10.21320/2500-2139-2016-9-4-369-382

РЕФЕРАТ

В обзоре описываются эпигенетические процессы, включая метилирование ядерной и митохондриальной ДНК, а также РНК. Рассматриваются механизмы деметилирования и препараты, обладающие этим свойством. Широко освещаются результаты многочисленных крупных рандомизированных исследований, посвященных изучению гипометилирующих средств (азануклеозидов). Особое внимание уделяется результатам терапии азануклеозидами у пациентов с острыми миелоидными лейкозами. В статье описаны некоторые прогностические системы и алгоритм лечения миелодиспластических синдромов. К настоящему времени в России одобрено к клиническому применению два азануклеозида: азацитидин (для п/к введения) и децитабин (для в/в введения). В зарубежных работах анализируется опыт применение децитабина внутрь и подкожно. Остается открытым вопрос об использовании гипометилирующих препаратов не по прямым показаниям (off-label). Кратко описываются проводимые новые клинические исследования с включением азануклеозидов.

Ключевые слова: эпигенетика, острые миелоидные лейкозы, миелодиспластические синдромы, азацитидин, децитабин, гипометилирующие препараты, азануклеозиды.

Получено: 10 мая 2016 г.

Принято в печать: 20 мая 2016 г.

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