Mucosal toxicity in hematological malignancies: prevention, management, and novel therapeutic insights.

IF 2.1 4区医学 Q2 HEMATOLOGY

Expert Review of Hematology Pub Date : 2025-08-13 DOI:10.1080/17474086.2025.2546118

Pasquale Niscola, Marco Giovannini

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引用次数: 0

Abstract

Introduction: Mucosal toxicities remain a longstanding and challenging concern in the treatment of hematopoietic malignancies (HM). In addition to the classic oral (OM) and gastrointestinal mucositis (GIM) induced by chemotherapy (CHT) and/or radiotherapy (RT), novel targeted treatments and immunotherapies may cause other forms of mucosal disorders.

Areas covered: This overview provides updated insights into the pathobiology and management strategies for mucosal toxicities induced by treatments for HMs. Additionally, it reappraises classic forms of mucositis and novel mucosal toxicities induced by new treatments for HMs.

Expert opinion: Although significant progress has been made in the pathophysiologic pathways of conventional CHT/RT-associated OM, much remains to be discovered. Indeed, OM and GIM have a multifactorial etiopathogenesis that includes direct effects, oxidative injury, upregulation of immunologic molecules, and changes in the microbiome. Preventive measures remain the cornerstone of management, mainly palliative in clinically established mucositis. However, new therapeutic insights, primarily related to mesenchymal cells and cytokine inhibitors, are emerging, and ongoing research is critical for translating these new findings into clinical practice.

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血液系统恶性肿瘤的粘膜毒性：预防、管理和新的治疗见解。

在造血恶性肿瘤（HM）的治疗中，粘膜毒性仍然是一个长期存在且具有挑战性的问题。除了由化疗（CHT）和/或放疗（RT）引起的经典口腔（OM）和胃肠道粘膜炎（GIM）外，新的靶向治疗和免疫疗法可能导致其他形式的粘膜疾病。涵盖领域：本综述提供了HMs治疗引起的粘膜毒性的病理生物学和管理策略的最新见解。此外，它重新评估经典形式的粘膜炎和新的黏膜毒性引起的新治疗HMs。专家意见：尽管在传统的CHT/ rt相关OM的病理生理途径方面取得了重大进展，但仍有许多有待发现。事实上，OM和GIM具有多因素的发病机制，包括直接作用、氧化损伤、免疫分子上调和微生物组的变化。预防措施仍然是管理的基石，主要是姑息治疗临床确定的粘膜炎。然而，主要与间充质细胞和细胞因子抑制剂相关的新的治疗见解正在出现，正在进行的研究对于将这些新发现转化为临床实践至关重要。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Expert Review of Hematology HEMATOLOGY-

CiteScore

4.70

自引率

3.60%

发文量

审稿时长

6-12 weeks

期刊介绍： Advanced molecular research techniques have transformed hematology in recent years. With improved understanding of hematologic diseases, we now have the opportunity to research and evaluate new biological therapies, new drugs and drug combinations, new treatment schedules and novel approaches including stem cell transplantation. We can also expect proteomics, molecular genetics and biomarker research to facilitate new diagnostic approaches and the identification of appropriate therapies. Further advances in our knowledge regarding the formation and function of blood cells and blood-forming tissues should ensue, and it will be a major challenge for hematologists to adopt these new paradigms and develop integrated strategies to define the best possible patient care. Expert Review of Hematology (1747-4086) puts these advances in context and explores how they will translate directly into clinical practice.