Purpose Serum ferritin is an independent prognostic marker in myelodysplastic neoplasms (MDS) and serves as a surrogate parameter for iron overload. Oxidative stress derived from iron overload may induce genomic damage, thereby promoting genetic instability and disease progression in MDS. We aimed to evaluate a possible association between iron overload via serum ferritin and various parameters for genetic instability in MDS.Methods Fifty-one patients with confirmed MDS were analyzed and divided into three groups based on ferritin levels: non-elevated (≤ 275 µg/L), moderately elevated (> 275 and 275 µg/L, whereas markers for advanced-stage genetic aberrations, including somatic mutations and cytogenetic aberrations, were more prominent at ferritin levels ≥ 1000 µg/L.Conclusion These findings support the hypothesis that iron overload, reflected by elevated ferritin as surrogate parameter, may contribute to and/or increase genetic instability in MDS patients with ineffective hematopoiesis. Notably, correlations were observed at ferritin levels below current thresholds for initiating iron chelation therapy, indicating clinical relevance early in the disease course.
Ganster et al. (Thu,) studied this question.