Elevated serum direct bilirubin is predictive of a poor prognosis for primary myelodysplastic syndrome
Abstract Background The aim of this study was to assess the prognostic significance of serum direct bilirubin (DBIL) for patients newly diagnosed with myelodysplastic syndromes (MDS). Methods The clinical, laboratory, and follow-up data of MDS patients were collected, and the associations of DBIL le...
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BMC
2024-11-01
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| Online Access: | https://doi.org/10.1186/s12885-024-13164-y |
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| author | Ying Chen Danqing Zhou Chao Ma Jie Cao Qiming Ying Lixia Sheng Xiao Yan Guifang Ouyang Qitian Mu |
| author_facet | Ying Chen Danqing Zhou Chao Ma Jie Cao Qiming Ying Lixia Sheng Xiao Yan Guifang Ouyang Qitian Mu |
| author_sort | Ying Chen |
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| description | Abstract Background The aim of this study was to assess the prognostic significance of serum direct bilirubin (DBIL) for patients newly diagnosed with myelodysplastic syndromes (MDS). Methods The clinical, laboratory, and follow-up data of MDS patients were collected, and the associations of DBIL levels with overall survival (OS) and leukemia-free survival (LFS) were analyzed. Result In total, 262 MDS patients were assigned to the high DBIL level group or the normal DBIL level group in the retrospective study. High DBIL was associated with older age, reduced hemoglobin, higher levels of β2-microglobin, lactate dehydrogenase, and serum ferritin, along with the number of co-mutations (> 1) and a higher frequency of ASXL1, KIT, and KRAS mutations. Multivariate analyses found that high DBIL level was an independent adverse predictor for OS (p = 0.002, hazard ratio = 2.723, 95%CI = 1.442–5.143) but not for LFS (p = 0.057, hazard ratio = 1.678, 95%CI = 0.986–2.857). A novel nomogram based on DBIL, sex, age, β2-microglobulin, lactate dehydrogenase, the Revised International Prognostic Scoring System (IPSS-R) was constructed, which demonstrated superior accuracy compared with the IPSS-R (C-index, 0.790 vs. 0.731, respectively). Conclusion An elevated DBIL level was identified as an independent adverse prognostic factor for MDS patients. An individualized prediction model was established and validated to improve prediction of OS and LFS. |
| format | Article |
| id | doaj-art-5aaa1cdd0aec4e2f985e9b6c9c66228a |
| institution | Kabale University |
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| language | English |
| publishDate | 2024-11-01 |
| publisher | BMC |
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| series | BMC Cancer |
| spelling | doaj-art-5aaa1cdd0aec4e2f985e9b6c9c66228a2024-11-17T12:32:39ZengBMCBMC Cancer1471-24072024-11-012411910.1186/s12885-024-13164-yElevated serum direct bilirubin is predictive of a poor prognosis for primary myelodysplastic syndromeYing Chen0Danqing Zhou1Chao Ma2Jie Cao3Qiming Ying4Lixia Sheng5Xiao Yan6Guifang Ouyang7Qitian Mu8Laboratory of Stem Cell Transplantation, The First Affiliated Hospital of Ningbo UniversityTraditional Chinese Medicine Department, Yinzhou Integrated TCM And Western Medicine HospitalLaboratory of Stem Cell Transplantation, The First Affiliated Hospital of Ningbo UniversityLaboratory of Stem Cell Transplantation, The First Affiliated Hospital of Ningbo UniversityDepartment of Blood Transfusion, The First Affiliated Hospital of Ningbo UniversityNingbo Clinical Research Center For Hematologic MalignanciesNingbo Clinical Research Center For Hematologic MalignanciesNingbo Clinical Research Center For Hematologic MalignanciesLaboratory of Stem Cell Transplantation, The First Affiliated Hospital of Ningbo UniversityAbstract Background The aim of this study was to assess the prognostic significance of serum direct bilirubin (DBIL) for patients newly diagnosed with myelodysplastic syndromes (MDS). Methods The clinical, laboratory, and follow-up data of MDS patients were collected, and the associations of DBIL levels with overall survival (OS) and leukemia-free survival (LFS) were analyzed. Result In total, 262 MDS patients were assigned to the high DBIL level group or the normal DBIL level group in the retrospective study. High DBIL was associated with older age, reduced hemoglobin, higher levels of β2-microglobin, lactate dehydrogenase, and serum ferritin, along with the number of co-mutations (> 1) and a higher frequency of ASXL1, KIT, and KRAS mutations. Multivariate analyses found that high DBIL level was an independent adverse predictor for OS (p = 0.002, hazard ratio = 2.723, 95%CI = 1.442–5.143) but not for LFS (p = 0.057, hazard ratio = 1.678, 95%CI = 0.986–2.857). A novel nomogram based on DBIL, sex, age, β2-microglobulin, lactate dehydrogenase, the Revised International Prognostic Scoring System (IPSS-R) was constructed, which demonstrated superior accuracy compared with the IPSS-R (C-index, 0.790 vs. 0.731, respectively). Conclusion An elevated DBIL level was identified as an independent adverse prognostic factor for MDS patients. An individualized prediction model was established and validated to improve prediction of OS and LFS.https://doi.org/10.1186/s12885-024-13164-yMyelodysplastic syndromesDirect bilirubinPrognosisIPSS-RIPSS-M |
| spellingShingle | Ying Chen Danqing Zhou Chao Ma Jie Cao Qiming Ying Lixia Sheng Xiao Yan Guifang Ouyang Qitian Mu Elevated serum direct bilirubin is predictive of a poor prognosis for primary myelodysplastic syndrome BMC Cancer Myelodysplastic syndromes Direct bilirubin Prognosis IPSS-R IPSS-M |
| title | Elevated serum direct bilirubin is predictive of a poor prognosis for primary myelodysplastic syndrome |
| title_full | Elevated serum direct bilirubin is predictive of a poor prognosis for primary myelodysplastic syndrome |
| title_fullStr | Elevated serum direct bilirubin is predictive of a poor prognosis for primary myelodysplastic syndrome |
| title_full_unstemmed | Elevated serum direct bilirubin is predictive of a poor prognosis for primary myelodysplastic syndrome |
| title_short | Elevated serum direct bilirubin is predictive of a poor prognosis for primary myelodysplastic syndrome |
| title_sort | elevated serum direct bilirubin is predictive of a poor prognosis for primary myelodysplastic syndrome |
| topic | Myelodysplastic syndromes Direct bilirubin Prognosis IPSS-R IPSS-M |
| url | https://doi.org/10.1186/s12885-024-13164-y |
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