Clinical study of iron metabolism indicators in ineffective hematopoiesis of myelodysplastic syndrome

Abstract

This study was purposed to investigate the iron metabolism changes and their clinical significance in myelodysplastic syndrome (MDS). Thirty eight transfusion independent MDS patients and 49 controls (21 AA patients, 28 normal volunteers) were enrolled in this study. The iron metabolism indicators including serum iron protein (SF), serum iron (SI), transferrin protein (Tf), total iron binding capacity (TIBC), transferrin saturation (TS), soluble transferrin receptor (sTfR) were detected, the intracellular and extracellular iron distribution were observed under microscope, the chromosome karyotype was analysis by FISH. The results showed that the serum SF, SI and TS levels in MDS group were lower than those in AA group, the serum SF value was higher than that in normal control group. There was no statistical difference between the SI, TS levels as compared with normal control group. The SI, TS levels showed a positive correlation with SF level(r = 0.281, P = 0.007; r = 0.338, P = 0.001, respectively). The serum TIBC in MDS group was no statistically significant difference from that in the control group. The Tf level in MDS group was higher than that in AA and normal control groups, and Tf level between later 2 groups did not show statistical difference. The proportion of sideroblasts in MDS group (57.19 ± 19.11%)was higher than that in AA group (35.00 ± 20.67%). The extracellular iron (+ + +- + + + +) (24%)was lower than that in AA group (33%), and bone marrow particle dyeable iron displayed mainly cocci-like distribution under microscope in patients with increased extracellular iron (+ + +- + + + +), while small need or massive distribution was observed in AA group.In addition, the abnormal chromosome karyotype was found in 15 out of 19 MDS cases (79%). There was no difference in iron metabolism indicators between the high-risk group and the low-risk group of MDS divided according to the International Prognostic Scoring System (WPSS). It is concluded that the iron loading in transfusion-independent patients obviously increases, displaying the enhancement of SF, Tf, intra-and extra-cellular iron, but lower than those in AA patients. It suggests that the abnormality exists in process of use, storage and discharge of iron in MDS patients.