Contributions
Abstract: PB2101
Type: Publication Only
Background
Myelodysplastic syndromes (MDS) are a heterogeneous group of hematologic disorders defined by ineffective hematopoiesis, manifesting in peripheral cytopenias. The progression of these clonal hematopoietic disorders is highly unpredictable and leukemic transformation is an often occurring hematological feature. No accurate prediction model has been so far established, due to the fact that no efficient prognostic markers have been identified.
Aims
The aim of this study was to evaluate whether the serum levels of ferritin, folic acid and vitamin B12 can be regarded as biomarkers of acute leukemic transformation in patients with MDS.
Methods
In this single-center, retrospective, registry-based study we included 128 patients diagnosed with primary MDS between 2012 and 2017. Data regarding serum levels of ferritin, folic acid, vitamin B12 were collected at the moment of diagnosis and during follow-ups. The initial medullary blast count and disease progression were also noted. The evaluated patients with MDS were divided into two groups: the patients with stable disease and those with leukemic progression.
Results
Out of the one hundred and twenty eight patients, 38.3 % (n=49) suffered disease progression and ultimately acute leukemia transformation, with a gender ratio of 61% male to 39% female. At the moment of diagnosis mean ferritin levels were lower in patients with stable disease 409.8 ng/ml vs. 504.5 ng/ml in patients with leukemic progression; whereas the opposite was observed for mean B12 and folate levels. The mean B12 levels were higher in stable disease patients 479.5 pg/ml vs, 455.2 pg/ml and the mean folate levels were 9.0 ng/ml vs. 8.0 ng/ml in patients with leukemic progression. The blast count at diagnosis was significantly higher in patients with disease progression into acute leukemia (8.8 vs 4.3) with a p < 0.001. Follow-up data revealed a significantly elevated Δferritin (ferritin last evaluation - ferritin diagnosis) in patients with subsequent acute leukemia transformation (1072.3 ng/ml vs. 680.4 ng/ml), p=0.006, highlighting a continuous trend of increase. An elevation of Δfolate levels (3.7 ng/ml vs. 4.7 ng/ml) and a decrease of ΔVitamin B12 levels (251.9 pg/ml vs. 213.4 pg/ml), without statistical significance, were also observed.
Conclusion
Despite the small sample size which may lead to possible type 2 statistical errors, the results of this study may be regarded as triggers for further research. Our results are pointing to a possible use of ferritin as a predictor for disease progression in patients with MDS. In the same time, the results are pointing to a lack of association between serum vitamin B12 or folic acid and the disease progression.
Session topic: 10. Myelodysplastic syndromes – Clinical
Keyword(s): Myelodysplasia, acute leukemia, Ferritin
Abstract: PB2101
Type: Publication Only
Background
Myelodysplastic syndromes (MDS) are a heterogeneous group of hematologic disorders defined by ineffective hematopoiesis, manifesting in peripheral cytopenias. The progression of these clonal hematopoietic disorders is highly unpredictable and leukemic transformation is an often occurring hematological feature. No accurate prediction model has been so far established, due to the fact that no efficient prognostic markers have been identified.
Aims
The aim of this study was to evaluate whether the serum levels of ferritin, folic acid and vitamin B12 can be regarded as biomarkers of acute leukemic transformation in patients with MDS.
Methods
In this single-center, retrospective, registry-based study we included 128 patients diagnosed with primary MDS between 2012 and 2017. Data regarding serum levels of ferritin, folic acid, vitamin B12 were collected at the moment of diagnosis and during follow-ups. The initial medullary blast count and disease progression were also noted. The evaluated patients with MDS were divided into two groups: the patients with stable disease and those with leukemic progression.
Results
Out of the one hundred and twenty eight patients, 38.3 % (n=49) suffered disease progression and ultimately acute leukemia transformation, with a gender ratio of 61% male to 39% female. At the moment of diagnosis mean ferritin levels were lower in patients with stable disease 409.8 ng/ml vs. 504.5 ng/ml in patients with leukemic progression; whereas the opposite was observed for mean B12 and folate levels. The mean B12 levels were higher in stable disease patients 479.5 pg/ml vs, 455.2 pg/ml and the mean folate levels were 9.0 ng/ml vs. 8.0 ng/ml in patients with leukemic progression. The blast count at diagnosis was significantly higher in patients with disease progression into acute leukemia (8.8 vs 4.3) with a p < 0.001. Follow-up data revealed a significantly elevated Δferritin (ferritin last evaluation - ferritin diagnosis) in patients with subsequent acute leukemia transformation (1072.3 ng/ml vs. 680.4 ng/ml), p=0.006, highlighting a continuous trend of increase. An elevation of Δfolate levels (3.7 ng/ml vs. 4.7 ng/ml) and a decrease of ΔVitamin B12 levels (251.9 pg/ml vs. 213.4 pg/ml), without statistical significance, were also observed.
Conclusion
Despite the small sample size which may lead to possible type 2 statistical errors, the results of this study may be regarded as triggers for further research. Our results are pointing to a possible use of ferritin as a predictor for disease progression in patients with MDS. In the same time, the results are pointing to a lack of association between serum vitamin B12 or folic acid and the disease progression.
Session topic: 10. Myelodysplastic syndromes – Clinical
Keyword(s): Myelodysplasia, acute leukemia, Ferritin