Abstract: BACKGROUND: Myelodysplastic syndrome (MDS) is a clonal hematopoietic stem cell disorder that predominantly affects the elderly and is characterized by bone marrow dysplasticity and cytopenia of the peripheral blood. Prompt and accurate diagnosis is essential for effective management and improvement of patient outcomes. However, current diagnostic standards rely on invasive and often inaccessible procedures such as bone marrow examination. OBJECTIVES: This study aimed to evaluate the diagnostic performance of a panel of noninvasive serum biomarkers, ferritin, beta-2 microglobulin (B2M), and lactate dehydrogenase (LDH), for the diagnosis of MDS in patients with unexplained cytopenias. MATERIALS AND METHODS: A case–control study was conducted involving 50 newly diagnosed patients with MDS and 50 healthy age- and sex-matched controls. Serum ferritin, B2M, LDH, and hepcidin levels were quantified using an enzyme-linked immunosorbent assay. RESULTS: Patients with MDS exhibited significantly elevated serum concentrations of ferritin, B2M, and LDH, as well as decreased levels of hepcidin compared to the control group. Ferritin demonstrated the highest individual diagnostic accuracy with an area under the curve (AUC) of 0.83. A combined panel of ferritin, B2M, and LDH yielded superior diagnostic performance, with an AUC of 0.88, sensitivity of 85%, and specificity of 82%. CONCLUSION: The serum biomarker panel comprising ferritin, B2M, and LDH demonstrates significant potential as a noninvasive tool for aiding in the diagnosis of MDS among patients presenting with unexplained cytopenias. To identify patients who warrant further investigation with more definitive procedures.
Al-khafaji et al. (Wed,) studied this question.