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

TITLE=Decreased transthyretin predicts a poor prognosis in primary myelodysplastic syndrome

JOURNAL=Frontiers in Nutrition

VOLUME=Volume 10 - 2023

YEAR=2023

URL=https://www.frontiersin.org/journals/nutrition/articles/10.3389/fnut.2023.1125768

DOI=10.3389/fnut.2023.1125768

ISSN=2296-861X

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 low 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, low 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 low transthyretin could be an independent adverse prognostic factor in patients with MDS and may provide a supplement to IPSS-R and IPSS-M.