Prognostic implications of low transferrin saturation in patients with primary myelofibrosis

Lucijanić, Marko; Prka, Željko; Pejša, Vlatko; Štoos‐Veić, Tajana; Lucijanic, Jelena; Kušec, Rajko

doi:10.1016/j.leukres.2018.01.017

Cited by 6 publications

(3 citation statements)

References 36 publications

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“…Recent studies have shown increased inflammatory activity in MPNs, especially in MF . It has also been shown that hepcidin levels as well as lowered Tsat correlate to inflammation and survival in MF.…”

Section: Introductionmentioning

confidence: 99%

Inflammatory functional iron deficiency common in myelofibrosis, contributes to anaemia and impairs quality of life. From the Nordic MPN study Group

Birgegård

Samuelsson

Ahlstrand

et al. 2019

European J of Haematology

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Objectives The study investigates the hypothesis that inflammation in myelofibrosis (MF) like in myeloma and lymphoma, may disturb iron distribution and contribute to anaemia. Methods A cross‐sectional study of 80 MF and 23 ET patients was performed. Results About 35% of anaemic MF patients had functional iron deficiency (FID) with transferrin saturation <20 and normal or elevated S‐ferritin (<500 µg/L). In ET, FID was rare. In MF patients with FID, 70.6% were anaemic, vs 29.4% in patients without FID (P = 0.03). Hepcidin was significantly higher in MF patients with anaemia, including transfusion‐dependent patients, 50.6 vs 24.4 µg/L (P = 0.01). There was a significant negative correlation between Hb and inflammatory markers in all MF patients: IL‐2, IL‐6 and TNF‐α, (P < 0.01‐0.03), LD (P = 0.004) and hepcidin (P = 0.03). These correlations were also seen in the subgroup of anaemic MF patients (Table ). Tsat correlated negatively with CRP (P < 0.001). Symptom burden was heavier in MF patients with FID, and MPN‐SAF quality of life scores correlated with IL‐6 and CRP. Conclusions The inflammatory state of MF disturbs iron turnover, FID is common and contributes to anaemia development and impairment of QoL. Anaemic MF patients should be screened for FID.

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Section: Introductionmentioning

confidence: 99%

Inflammatory functional iron deficiency common in myelofibrosis, contributes to anaemia and impairs quality of life. From the Nordic MPN study Group

Birgegård

Samuelsson

Ahlstrand

et al. 2019

European J of Haematology

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“…Lucijanic et al evaluated the prognostic impact of low TS in 87 patients with PMF. Low TS was found to have a detrimental effect on the survival of PMF patients, independent of anemia and ferritin levels 27 . In the present study, ferritin level was found to be higher in patients with mortality (p = 0.024) and when included in the multivariate Cox regression model, it was found that an increase in ferritin levels increased the risk of mortality (HR 1.00; 95% CI 1.00–1.01 p = 0.002).…”

Section: Discussionmentioning

confidence: 93%

Systemic inflammatory indices for predicting prognosis of myelofibrosis

Ersal

Özkocaman

Pınar

et al. 2023

Sci Rep

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The impact of inflammatory markers such as systemic immune-inflammation (SII) index and systemic inflammation response index (SIRI) on myelofibrosis (MF) prognosis was evaluated for the first time in this study. Data from 60 patients diagnosed with MF between March 2011 and September 2022 were retrospectively analyzed. In addition to disease-related markers, the impact of SII and SIRI on prognosis was evaluated. In our study, the overall median survival (OS) was 64 months. OS was significantly shorter in patients older than 65 years, with high ferritin and lymphocyte levels, transfusion dependence at diagnosis, platelet count below 100 × 109/L, Hb level below 8 g/dl, and high risk according to the dynamic international prognostic scoring system (DIPSS)-Plus score. When these variables were included in the multivariate Cox regression model, it was found that being older than 65 years, having a high ferritin value, being at high risk according to the DIPSS-plus score and Hb values below 8 increased the risk of death. Platelet-to-lymphocyte ratio (PLR) and SII index were lower in patients with a fatal outcome. No statistically significant relationship was found between SIRI and mortality. The findings of this study showed that low PLR and high ferritin were associated with poor prognosis in MF. Elevated SII and SIRI, evaluated for the first time in patients with myelofibrosis, did not predict prognosis. Since non-inflammatory variables play a role in the pathogenesis of MF, bone marrow indicators and systemic inflammation indicators derived from hematologic parameters may not be accurate.

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“…Neutrophil-to-lymphocyte-ratio (NLR) and platelet-tolymphocyte-ratio (PLR) are inflammatory biomarkers that have been consistently associated with poor clinical outcomes in a variety of malignant (11)(12)(13)(14)(15) and cardiovascular diseases (16)(17)(18)(19) when elevated. Ph-MPNs are burdened with significant cardiovascular morbidity (20) and many predictors of decreased cardiovascular survival were shown to be prognostic in myelofibrosis as well (21)(22)(23)(24)(25). However, NLR and PLR have not been thoroughly studied in Ph-MPN patients so far.…”

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confidence: 99%

Elevated Neutrophil–to–Lymphocyte-ratio and Platelet–to–Lymphocyte Ratio in Myelofibrosis: Inflammatory Biomarkers or Representatives of Myeloproliferation Itself?

Lucijanić

Cicic

Štoos‐Veić

et al. 2018

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Prognostic implications of low transferrin saturation in patients with primary myelofibrosis

Cited by 6 publications

References 36 publications

Inflammatory functional iron deficiency common in myelofibrosis, contributes to anaemia and impairs quality of life. From the Nordic MPN study Group

Inflammatory functional iron deficiency common in myelofibrosis, contributes to anaemia and impairs quality of life. From the Nordic MPN study Group

Systemic inflammatory indices for predicting prognosis of myelofibrosis

Elevated Neutrophil–to–Lymphocyte-ratio and Platelet–to–Lymphocyte Ratio in Myelofibrosis: Inflammatory Biomarkers or Representatives of Myeloproliferation Itself?

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