Gloria Moreno Carrasco, Rodolfo Matias Ortiz Flores, Regina García Delgado, Borja Cidoncha Morcillo, Ana Isabel Rosell Mas, Dana Díaz Canales, María Rodríguez González, Manuel Carrasco Gomariz, Alejandro Escamilla-Sánchez
{"title":"治疗前血清铁蛋白对阿扎胞苷治疗骨髓增生异常综合征的疗效和生存率的影响：一项多因素分析","authors":"Gloria Moreno Carrasco, Rodolfo Matias Ortiz Flores, Regina García Delgado, Borja Cidoncha Morcillo, Ana Isabel Rosell Mas, Dana Díaz Canales, María Rodríguez González, Manuel Carrasco Gomariz, Alejandro Escamilla-Sánchez","doi":"10.1002/cam4.71127","DOIUrl":null,"url":null,"abstract":"<div>\n \n \n <section>\n \n <h3> Background</h3>\n \n <p>Myelodysplastic syndromes (MDS) encompass a heterogeneous group of haematological neoplasms characterized by ineffective haematopoiesis and a variable risk of transformation to acute myeloid leukaemia (AML). Elevated serum ferritin (SF), a marker of iron overload (IO), has been linked to poorer outcomes in MDS. However, the impact of pre-treatment SF levels on azacytidine (AZA) response and survival outcomes remains unclear.</p>\n </section>\n \n <section>\n \n <h3> Methods</h3>\n \n <p>This retrospective cohort study included patients with World Health Organization-defined MDS or AML with 20%–30% bone marrow blasts treated with AZA at the Virgen de la Victoria University Hospital (Málaga, Spain) from 2007 onwards. Patients were stratified into three groups based on pre-treatment SF levels: < 500 ng/mL, 500–1000 ng/mL and > 1000 ng/mL. Logistic regression and Kaplan–Meier methods were used to analyse overall response (OR) and overall survival (OS).</p>\n </section>\n \n <section>\n \n <h3> Results</h3>\n \n <p>Among 240 patients, 190 with available SF data were analysed. Patients with SF > 1000 ng/mL showed significantly lower OR (24.2%) and shorter OS (median: 10.1 months) compared to those with SF < 500 ng/mL (OR: 71.4%, OS: 18.2 months) and 500–1000 ng/mL (OR: 82.6%, OS: 20.5 months) (<i>p</i> < 0.0001 for OR, <i>p</i> = 0.001 for OS). Multivariate analysis confirmed elevated SF as an independent predictor of poorer outcomes.</p>\n </section>\n \n <section>\n \n <h3> Conclusions</h3>\n \n <p>Elevated pre-treatment SF levels are strongly associated with reduced response and survival in patients with MDS or AML treated with AZA. Early IO management, such as iron chelation, may improve treatment outcomes.</p>\n </section>\n </div>","PeriodicalId":139,"journal":{"name":"Cancer Medicine","volume":"14 15","pages":""},"PeriodicalIF":3.1000,"publicationDate":"2025-08-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/cam4.71127","citationCount":"0","resultStr":"{\"title\":\"Impact of Pre-Treatment Serum Ferritin on Response and Survival in Myelodysplastic Syndromes Treated With Azacytidine: A Multivariate Analysis\",\"authors\":\"Gloria Moreno Carrasco, Rodolfo Matias Ortiz Flores, Regina García Delgado, Borja Cidoncha Morcillo, Ana Isabel Rosell Mas, Dana Díaz Canales, María Rodríguez González, Manuel Carrasco Gomariz, Alejandro Escamilla-Sánchez\",\"doi\":\"10.1002/cam4.71127\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div>\\n \\n \\n <section>\\n \\n <h3> Background</h3>\\n \\n <p>Myelodysplastic syndromes (MDS) encompass a heterogeneous group of haematological neoplasms characterized by ineffective haematopoiesis and a variable risk of transformation to acute myeloid leukaemia (AML). Elevated serum ferritin (SF), a marker of iron overload (IO), has been linked to poorer outcomes in MDS. However, the impact of pre-treatment SF levels on azacytidine (AZA) response and survival outcomes remains unclear.</p>\\n </section>\\n \\n <section>\\n \\n <h3> Methods</h3>\\n \\n <p>This retrospective cohort study included patients with World Health Organization-defined MDS or AML with 20%–30% bone marrow blasts treated with AZA at the Virgen de la Victoria University Hospital (Málaga, Spain) from 2007 onwards. Patients were stratified into three groups based on pre-treatment SF levels: < 500 ng/mL, 500–1000 ng/mL and > 1000 ng/mL. Logistic regression and Kaplan–Meier methods were used to analyse overall response (OR) and overall survival (OS).</p>\\n </section>\\n \\n <section>\\n \\n <h3> Results</h3>\\n \\n <p>Among 240 patients, 190 with available SF data were analysed. Patients with SF > 1000 ng/mL showed significantly lower OR (24.2%) and shorter OS (median: 10.1 months) compared to those with SF < 500 ng/mL (OR: 71.4%, OS: 18.2 months) and 500–1000 ng/mL (OR: 82.6%, OS: 20.5 months) (<i>p</i> < 0.0001 for OR, <i>p</i> = 0.001 for OS). Multivariate analysis confirmed elevated SF as an independent predictor of poorer outcomes.</p>\\n </section>\\n \\n <section>\\n \\n <h3> Conclusions</h3>\\n \\n <p>Elevated pre-treatment SF levels are strongly associated with reduced response and survival in patients with MDS or AML treated with AZA. 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Impact of Pre-Treatment Serum Ferritin on Response and Survival in Myelodysplastic Syndromes Treated With Azacytidine: A Multivariate Analysis
Background
Myelodysplastic syndromes (MDS) encompass a heterogeneous group of haematological neoplasms characterized by ineffective haematopoiesis and a variable risk of transformation to acute myeloid leukaemia (AML). Elevated serum ferritin (SF), a marker of iron overload (IO), has been linked to poorer outcomes in MDS. However, the impact of pre-treatment SF levels on azacytidine (AZA) response and survival outcomes remains unclear.
Methods
This retrospective cohort study included patients with World Health Organization-defined MDS or AML with 20%–30% bone marrow blasts treated with AZA at the Virgen de la Victoria University Hospital (Málaga, Spain) from 2007 onwards. Patients were stratified into three groups based on pre-treatment SF levels: < 500 ng/mL, 500–1000 ng/mL and > 1000 ng/mL. Logistic regression and Kaplan–Meier methods were used to analyse overall response (OR) and overall survival (OS).
Results
Among 240 patients, 190 with available SF data were analysed. Patients with SF > 1000 ng/mL showed significantly lower OR (24.2%) and shorter OS (median: 10.1 months) compared to those with SF < 500 ng/mL (OR: 71.4%, OS: 18.2 months) and 500–1000 ng/mL (OR: 82.6%, OS: 20.5 months) (p < 0.0001 for OR, p = 0.001 for OS). Multivariate analysis confirmed elevated SF as an independent predictor of poorer outcomes.
Conclusions
Elevated pre-treatment SF levels are strongly associated with reduced response and survival in patients with MDS or AML treated with AZA. Early IO management, such as iron chelation, may improve treatment outcomes.
期刊介绍：
Cancer Medicine is a peer-reviewed, open access, interdisciplinary journal providing rapid publication of research from global biomedical researchers across the cancer sciences. The journal will consider submissions from all oncologic specialties, including, but not limited to, the following areas:
Clinical Cancer Research
Translational research ∙ clinical trials ∙ chemotherapy ∙ radiation therapy ∙ surgical therapy ∙ clinical observations ∙ clinical guidelines ∙ genetic consultation ∙ ethical considerations
Cancer Biology:
Molecular biology ∙ cellular biology ∙ molecular genetics ∙ genomics ∙ immunology ∙ epigenetics ∙ metabolic studies ∙ proteomics ∙ cytopathology ∙ carcinogenesis ∙ drug discovery and delivery.
Cancer Prevention:
Behavioral science ∙ psychosocial studies ∙ screening ∙ nutrition ∙ epidemiology and prevention ∙ community outreach.
Bioinformatics:
Gene expressions profiles ∙ gene regulation networks ∙ genome bioinformatics ∙ pathwayanalysis ∙ prognostic biomarkers.
Cancer Medicine publishes original research articles, systematic reviews, meta-analyses, and research methods papers, along with invited editorials and commentaries. Original research papers must report well-conducted research with conclusions supported by the data presented in the paper.
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