Current Hematologic Malignancy Reports

, Volume 13, Issue 4, pp 244–255 | Cite as

Disordered Immune Regulation and its Therapeutic Targeting in Myelodysplastic Syndromes

  • Kathryn S. Ivy
  • P. Brent FerrellJrEmail author
Myelodysplastic Syndromes (M Savona, Section Editor)
Part of the following topical collections:
  1. Topical Collection on Myelodysplastic Syndromes


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.


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.


Myelodysplastic syndromes Inflammation Immune dysregulation Bone marrow microenvironment Immunotherapy 


Compliance with Ethical Standards

Conflict of Interest

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

Human and Animal Rights and Informed Consent

This article does not contain any studies with human or animal subjects performed by any of the authors.


Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major Importance

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Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Boston University School of MedicineBostonUSA
  2. 2.Department of MedicineVanderbilt University Medical CenterNashvilleUSA
  3. 3.Vanderbilt-Ingram Cancer CenterVanderbilt University Medical CenterNashvilleUSA

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