Oliva Esther Natalie, Huey Krystal, Deshpande Sohan, Turner Monica, Chitnis Madhura, Schiller Emma, Tang Derek, Yucel Aylin, Hughes Christina, Shah Farrukh
Hematology Unit, Grande Ospedale Metropolitano Bianchi Melacrino Morelli, 89124 Reggio Calabria, Italy.
Bristol Myers Squibb, Princeton, NJ 08540, USA.
J Clin Med. 2022 Feb 8;11(3):895. doi: 10.3390/jcm11030895.
Anemia is the most common form of cytopenia in patients with myelodysplastic syndromes (MDS), who require chronic red blood cell transfusions and may present high serum ferritin (SF) levels as a result of iron overload. To better understand the potential effects of high SF levels, we conducted a systematic literature review (SLR) to identify evidence on the relationship between SF levels and clinical, economic, or humanistic outcomes in adult patients with MDS. Of 267 references identified, 21 were included. No studies assessing SF levels and their relationship with humanistic or economic outcomes were identified. Increased SF levels were an indicator of worse overall survival and other worsened outcomes; however, the association was not consistently significant. SF levels were a significant prognostic factor for relapse incidence of MDS and showed a significant positive correlation with number of blood units transfused but were not associated with progression to acute myeloid leukemia or the time to transformation. Higher SF levels were also an indicator of a lower likelihood of leukemia-free survival, relapse-free survival, and event-free survival. The SLR suggests that SF levels are associated with clinical outcomes in MDS, with higher levels correlated with number of blood units transfused, frequently indicating worse outcomes.
贫血是骨髓增生异常综合征（MDS）患者中最常见的血细胞减少形式，这些患者需要长期输注红细胞，并且由于铁过载可能出现高血清铁蛋白（SF）水平。为了更好地了解高SF水平的潜在影响，我们进行了一项系统文献综述（SLR），以确定关于成年MDS患者SF水平与临床、经济或人文结局之间关系的证据。在识别出的267篇参考文献中，纳入了21篇。未发现评估SF水平及其与人文或经济结局关系的研究。SF水平升高是总体生存率较差和其他不良结局的一个指标；然而，这种关联并不始终显著。SF水平是MDS复发发生率的一个重要预后因素，与输注的血液单位数量呈显著正相关，但与进展为急性髓系白血病或转化时间无关。较高的SF水平也是无白血病生存、无复发生存和无事件生存可能性较低的一个指标。该系统文献综述表明，SF水平与MDS的临床结局相关，较高水平与输注的血液单位数量相关，通常表明结局较差。
