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Increased serum C-reactive protein is an adverse prognostic factor in low-risk myelodysplastic syndromes

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Abstract

Inflammatory cytokines play a role in hematopoiesis and development of myelodysplastic syndromes (MDS). Although increased serum levels of inflammatory cytokines are associated with poor survival in MDS patients, clinical management does not include assessment of inflammation. We investigated the significance of inflammation in MDS using serum C-reactive protein (CRP) levels, an indicator of the degree of systemic inflammation that can be used in routine practice. We hypothesized that serum CRP levels can be used to further classify low-risk MDS. We conducted a retrospective analysis of 90 patients with low-risk MDS, defined by the international prognostic scoring system (IPSS). We examined the prognostic relevance of CRP and known prognostic factors at diagnosis. Increased serum CRP (≥ 0.58 mg/dL) was associated with poor survival (hazard ratio [HR]: 17.63, 95% confidence interval [CI] 5.83–53.28, P < 0.001) both overall and among the 73 patients with low-risk MDS as defined by the revised IPSS (HR: 28.05, 95% CI 6.15–128.04, P < 0.001). Increased CRP might predict poor prognosis and serum CRP levels can indicate clonal hematopoiesis and non-hematological comorbidity in patients with low-risk MDS.

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Acknowledgements

All the authors reviewed the paper and agreed with the final version. We thank all the physicians, nurses, and staff who contributed to the patient care. We thank Eisuke Inoue (Showa University Research Administration Center) for their generous support.

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Authors and Affiliations

  1. Division of Hematology, Department of Medicine, Showa University School of Medicine, 1-5-8 Hatanodai, Shinagawa-Ku, Tokyo, 142-8666, Japan

    Yuta Baba, Bungo Saito, Shotaro Shimada, Yohei Sasaki, Shun Fujiwara, Nana Arai, Yukiko Kawaguchi, Yui Uto, Kouji Yanagisawa, Norimichi Hattori & Tsuyoshi Nakamaki

  2. Division of Hematology, Department of Medicine, Showa University Fujigaoka Hospital, 1-30, Fujigaoka, Aoba-Ku, Yokohama, 227-8501, Japan

    Yuta Baba, Nobuyuki Kabasawa, Hiroyuki Tsukamoto & Hiroshi Harada

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  1. Yuta Baba
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Correspondence to Yuta Baba.

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Baba, Y., Saito, B., Shimada, S. et al. Increased serum C-reactive protein is an adverse prognostic factor in low-risk myelodysplastic syndromes. Int J Hematol 114, 441–448 (2021). https://doi.org/10.1007/s12185-021-03187-7

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  • DOI: https://doi.org/10.1007/s12185-021-03187-7

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