Interferons (IFNs) are pleiotropic cytokines involved in antiviral defense, immune regulation, and tumor suppression. In myeloproliferative neoplasms (MPNs) and related disorders—including classical BCR, ABL1-negative MPNs, chronic myeloid leukemia (CML), and rarer entities such as chronic neutrophilic leukemia and hypereosinophilic syndromes—disease pathogenesis arises from a spectrum of somatic and structural genetic abnormalities and chronic inflammation, in which IFNs play a paradoxical role. They contribute to disease pathogenesis by promoting abnormal hematopoiesis and immune dysregulation, while also representing a therapeutic option capable of inducing hematologic and molecular remissions. This review outlines the biology and classification of IFNs, focusing on their signaling pathways and downstream effects in both normal and malignant hematopoiesis. We discuss the dual impact of IFN signaling on hematopoietic stem cells, including induction of proliferation, senescence, apoptosis, and DNA damage, and how these mechanisms may both sustain clonal evolution and facilitate disease control. Clinical data supporting the efficacy and safety of IFN-α, particularly pegylated formulations, in polycythemia vera, essential thrombocythemia, myelofibrosis, and chronic myeloid leukemia are reviewed, along with insights into next-generation IFNs and combination therapies. Understanding the dichotomous effects of IFNs in MPNs not only clarifies their role in disease biology but also informs their optimal use in clinical practice. This duality highlights the need for personalized approaches to IFN-based therapies.
干扰素是一类具有抗病毒防御、免疫调节和肿瘤抑制功能的多效性细胞因子。在骨髓增殖性肿瘤及相关疾病（包括经典BCR-ABL1阴性骨髓增殖性肿瘤、慢性髓系白血病，以及慢性中性粒细胞白血病、高嗜酸性粒细胞综合征等罕见类型）中，疾病发生发展源于一系列体细胞与结构性遗传异常及慢性炎症过程，而干扰素在其中扮演着矛盾角色：既通过促进异常造血和免疫失调参与疾病进程，又作为治疗手段能够诱导血液学及分子学缓解。本文系统阐述干扰素的生物学特性与分类体系，重点解析其在正常及恶性造血过程中的信号传导通路与下游效应。我们探讨干扰素信号对造血干细胞的双重影响，包括诱导增殖、衰老、凋亡和DNA损伤等机制，并阐释这些机制如何同时维持克隆演变与促进疾病控制。通过综述聚乙二醇化干扰素-α在真性红细胞增多症、原发性血小板增多症、骨髓纤维化及慢性髓系白血病中的疗效与安全性临床数据，结合对新一代干扰素及联合治疗方案的展望，深入理解干扰素在骨髓增殖性肿瘤中的双重作用，不仅有助于阐明其在疾病生物学中的角色，更能指导临床实践中的优化应用。这种双重性凸显了干扰素疗法需要个体化精准实施的必要性。
肿瘤(癌症)患者之家