Decreased transthyretin predicts a poor prognosis in primary myelodysplastic syndrome

Ying Chen; Tingting Niu; Ting Chen; Yue Wu; Duobing Zou; Cong Shi; Ying Wu; Zhaoyi Zhang; Ningning Wu; Yi Zhang; Xiao Yan; Lixia Sheng; Dingfeng Lv; Guifang Ouyang; Xueqin Chen; Qitian Mu

doi:10.3389/fnut.2023.1125768

Decreased transthyretin predicts a poor prognosis in primary myelodysplastic syndrome

Front Nutr. 2023 Mar 7:10:1125768. doi: 10.3389/fnut.2023.1125768. eCollection 2023.

Authors

Ying Chen^{1

2}, Tingting Niu^{1

2}, Ting Chen^{3

4}, Yue Wu^{1

4}, Duobing Zou^{1

2}, Cong Shi^{1

2}, Ying Wu^{1

2}, Zhaoyi Zhang^{1

2}, Ningning Wu^{1

2}, Yi Zhang^{1

2}, Xiao Yan^{2

3}, Lixia Sheng^{2

3}, Dingfeng Lv⁵, Guifang Ouyang^{2

3}, Xueqin Chen⁶, Qitian Mu^{1

2}

Affiliations

¹ Laboratory of Stem Cell Transplantation, Ningbo First Hospital, Ningbo, Zhejiang, China.
² Ningbo Clinical Research Center For Hematologic Malignancies, Ningbo, Zhejiang, China.
³ Hematology Department, Ningbo First Hospital, Ningbo, Zhejiang, China.
⁴ Medical School of Ningbo University, Ningbo, China.
⁵ Department of Blood Transfusion, Ningbo First Hospital, Ningbo, China.
⁶ Department of Traditional Medicine, Ningbo First Hospital, Ningbo, Zhejiang, China.

Abstract

Background: This study aims to investigate the prognostic significance of transthyretin in newly diagnosed myelodysplastic syndromes (MDS).

Methods: The clinical, laboratory, and follow-up data of 280 newly diagnosed patients with MDS were collected. The relationship between serum transthyretin levels and overall survival (OS) and leukemia-free survival (LFS) were analyzed by Kaplan-Meier analysis and Cox Regression Model.

Result: In the MDS cohort, there were 121 cases in the low transthyretin group and 159 cases in the normal transthyretin group. MDS patients with decreased transthyretin had a higher risk score on the Revised International Prognostic Scoring System (IPSS-R) (p = 0.004) and on the molecular IPSS (IPSS-M) (p = 0.005), a higher frequency of TP53 mutation (p < 0.0001), a shorter OS (p < 0.0001) and LFS (p < 0.0001). Multivariate analyses showed that higher IPSS-R and IPSS-M score were adverse factors for OS (p = 0.008 and p = 0.015, respectively) and LFS (p = 0.024 and p = 0.005, respectively). Mutations of TP53 and NRAS were also poor factors for LFS (p = 0.034 and p = 0.018, respectively). Notably, decreased transthyretin was an independent adverse predictor for OS (p = 0.009, HR = 0.097, 95%CI, 0.017-0.561) but not for LFS (p = 0.167) when IPSS-R was included in the Cox regression model and an independent poor one for OS (p = 0.033, HR = 0.267, 95%CI, 0.080-0.898) and LFS (p = 0.024, HR = 0.290, 95%CI, 0.099-0.848) while IPSS-M involved.

Conclusion: The results indicate that decreased transthyretin could be an independent adverse prognostic factor in patients with MDS and may provide a supplement to IPSS-R and IPSS-M.

Keywords: IPSS-M; IPSS-R; myelodysplastic syndromes; prognosis; transthyretin.