Paired peripheral blood and bone marrow IL-6 and TNF-α protein and transcript profiles in myelodysplastic syndrome: A pilot study

Cytokine dysregulation contributes to the pathophysiology of myelodysplastic syndrome (MDS); however, cytokine assessment may vary by biological compartment (peripheral blood [PB] versus bone marrow [BM]) and molecular level (proteomic versus transcriptomic). We profiled paired PB and BM IL-6 and TNF-α at the proteomic and transcriptomic levels using ELISA and RT-qPCR, respectively, and summarised within-patient patterns and directional relationships. Seven untreated patients with confirmed MDS (mean age 59.4 years; SD 25.6; range 4–77; 4/7 male) provided paired samples. At the proteomic level, TNF-α showed uniform PB > BM directionality (7/7; exact two-sided sign-test p = 0.016; Wilcoxon W = 0, p = 0.016), while transcriptomic measurements were predominantly PB-leaning (6/7; p = 0.125; W = 7, p = 0.297). In contrast, IL-6 showed heterogeneous PB-BM patterns at the proteomic (PB > BM in 4/7; p = 1.000; W = 7, p = 0.297) and transcriptomic (BM > PB in 5/7; p = 0.453; W = 5, p = 0.156) levels. Sensitivity analyses excluding the paediatric patient retained the main directions. Cross-analyte plots indicated limited proteomic-transcriptomic concordance. These hypothesis-generating findings require confirmation in larger, age-stratified studies.