Changes and significance of serum ferritin level in patients with myelodysplastic syndrome

LIU Chao; QIN Haoren; JI Hongxia; LIU Yaoyao; YANG Xiangdong

doi:10.3969/j.issn.1002-266X.2017.48.006

Abstract：Objective To investigate the changes and clinical significance of serum ferritin (SF) level in patients with primary myelodysplastic syndrome (MDS).Methods Fifty cases of newly diagnosed MDS patients were selected,including different sub-types (6 cases of RA type,4 RARS,20 RCMD,13 RAEB-1,and 7 RAEB-2) and different IPSS-R classifications (3 cases of very low risk,8 cases of low risk,20 cases of intermediate risk,15 cases of high risk,and 4 cases of very high risk).First of all,the blood samples were taken before and after transfusion of red blood cells at 10,20 and 30 U,respectively,then we measured SF level in each sample by radioimmunoassay and calculates the difference of SF (SF△).At last,we analyzed the relationship of SF△ level with different blood transfusion volume,different sub-type and IPSS-R classification.When the infusion of red blood cells were up to 30 U,we divided the patients into the SF△≥2 000 ng/mL group and SF△ ＜ 2 000 ng/mL group,and we compared the prognosis of patients between these two groups.Results The levels of SF in patients with RARS,RAEB-1,and RAEB-2 types were higher than those of patients with RA and RCMD types (all P ＜ 0.05);the levels of SF in the high-risk and very-high-risk patients were apparently higher than those in the very-low-risk,low-risk and intermediate-risk patients (all P ＜ 0.5).Serum SF△ levels were lower in patients with RAEB-1 and RAEB-2 types than those in the other types at the blood transfusion of 20 and 30 U (all P ＜ 0.05).Serum SF△ levels in the high-risk and very-high-risk patients with erythrocytes up to 30 U were lower than those in the other risk patients (all P ＜0.05).All patients were followed up to June 2016.When the infusion of red blood cells were up to 30 U,the transformation rate of MDS/AML in the SF△≥2 000 ng/ml group was lower than that in the SF△ ＜2 000 ng/ml group,and the whole median survival time in the SF△ ≥2 000 ng/ml group was longer (P ＜ 0.01).Conclusions The serum SF levels in newly diagnosed MDS patients with RARS,RAEB-1,RAEB-2 types,and in high-risk and very-high-risk patients are higher than those of other sub-types and risk classifications.With the increase of blood transfusion,the level of iron overload in patients with RAEB-1 and RAEB-2 types and in high-risk and very-high-risk patients are higher than those of the other sub-types and risk classifications.The change of serum SF may predict the prognosis of patients with MDS.