title: Serum ferritin is an independent prognostic factor in Chinese with myelodysplastic syndromes classified as IPSS Intermediate-1.
abstract: BACKGROUND
  The International Prognostic Staging System (IPSS) for myelodysplastic syndromes (MDS) was developed predominately in patients of European ancestry and is not validated in Asians. In a recently revised IPSS (IPSS-R), several new prognostic variables are included, i.e. age, Eastern Cooperative Oncology Group performance score (ECOG PS), serum ferritin and lactate dehydrogenase. Chinese with MDS offer a unique opportunity to distinguish the prognostic impacts of haemoglobin (HGB) concentration, red blood cell (RBC) transfusions and serum ferritin because in China, patients rarely receive RBC transfusions unless the HGB concentration is <6.0 g/dl.
  
  
  METHODS
  We studied prognostic variables in 191 untreated Chinese primary patients with MDS intermediate-1 (INT-1) in the IPSS.
  
  
  RESULTS
  Serum ferritin level ≥500 µg/l at diagnosis was a strong independent predictor of survival. Although baseline serum ferritin level was inversely correlated with baseline HGB, it was the serum ferritin, not the baseline HGB level, that was significantly correlated with survival in Chinese patients. A new prognostic scoring system including the ECOG PS, absolute neutrophil level, serum ferritin, percentage of bone marrow blasts and poor karyotype was developed for Chinese with IPSS INT-1 MDS.
  
  
  CONCLUSIONS
  This revised scoring system identified a subgroup of Chinese with MDS and INT-1 IPPS who have a poor prognosis and may benefit from more intensive therapy.
authors: MDS and MPN Centre, Institute of Haematology and Blood Diseases Hospital, Chinese Academy of Medical Sciences, Tianjin, China.
authors: Bing
authors: B
authors: Li
authors: Zefeng
authors: Z
authors: Xu
authors: Robert Peter
authors: RP
authors: Gale
authors: Tiejun
authors: T
authors: Qin
authors: Yue
authors: Y
authors: Zhang
authors: Zhijian
authors: Z
authors: Xiao
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D044466:Asian People; D002648:Child; D002681:China; D005260:Female; D005293:Ferritins / Q000097:blood*; D005500:Follow-Up Studies; D006454:Hemoglobins / Q000032:analysis; D006801:Humans; D008297:Male; D008875:Middle Aged; D009190:Myelodysplastic Syndromes / Q000097:blood / Q000175:diagnosis* / Q000401:mortality; D011379:Prognosis; D012720:Severity of Illness Index; D016019:Survival Analysis; D055815:Young Adult
chemical_list: D006454:Hemoglobins; D005293:Ferritins