Title: Ferritin: Is it a Predictor of Prognosis in Myelodysplastic Syndrome?
Abstract: Objective: Although transfusion load is considered to be the main cause of iron overload (IO) in myelodysplastic syndrome (MDS), patients without transfusion history may also present with IO at diagnosis. This retrospective study was assessed to investigate the potential role of baseline ferritin in MDS prognosis. Material and Methods: A total of 87 patients median age: 62(21-83); male/female: 53/34] were included in this study. Results: Serum ferritin levels, which were positively correlated with International Prognostic Scoring System (IPSS), World Health Organization Prognostic Scoring System (WPSS), C reactive protein (CRP) and lactate dehydrogenase (LDH) levels, were relatively higher in patients with excess marrow blasts (¡İ5%) at diagnosis. Serum CRP, reticulocyte percentage, LDH and alanine transaminase levels were higher as well as IPSS and WPSS, while hemoglobin and platelet count were lower in the high-ferritin group. Percentage of marrow blasts at diagnosis, IPSS and WPSS had significant prognostic impact on overall survival. Although ferritin levels were associated with certain prognostic markers, an independent impact of ferritin on prognosis or survival was not demonstrated. Conclusion: The prognostic role of ferritin should be confirmed in larger prospective studies in order to include this feasible candidate in standard prognostic scoring systems in MDS.