In myelodysplastic syndrome cases, what should be the level of ferritin which has prognostic value?

Myelodysplastic syndrome (MDS) is a highly mortal disease in which anemia is unresponsive to treatment. In this study, the effect of basal ferritin values on prognosis and survival was investigated in MDS patients without history of transfusion. Data were retrospectively analyzed for 62 MDS cases. The cases were divided into two groups according to ferritin values. The mean survival time was 61.1 ± 4.8 months. During the follow-up period, 34 (54.8%) patients deceased. Median ferritin level was 358 ng/mL. The serum ferritin (SF) level associated with mortality was determined as 400 ng/mL (ROC area for SF was 0.731 with a cutoff value of 400; sensitivity and specificity were 70.7% and 68.2%, respectively) (P = 0.002). There were 29 (46.8%) patients with serum ferritin levels of ≥ 400 ng/mL. Patients with serum ferritin levels ≥ 400 ng/mL had low survival rates. Ferritin ≥ 400 ng/mL was associated with six times increased mortality (P = 0.001). Although the acceptable ferritin level at the start of chelation therapy is 1000 ng/mL, the fact that 400 ng/mL value is associated with survival in our study suggests that it may be useful to start chelation therapy in the early period. Further case studies on the subject are required. [ABSTRACT FROM AUTHOR]