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Myelodysplastic Syndromes
Dyserythropoiesis evaluated by the RED score and hepcidin:ferritin ratio predicts response to erythropoietin in lower-risk myelodysplastic syndromes
Ferrata Storti Foundation
Haematologica 2019 Volume 104(3):497-504
Sophie Park,1,2 Olivier Kosmider,3 Frédéric Maloisel,4 Bernard Drenou,5 Nicolas Chapuis,6 Thibaud Lefebvre,7 Zoubida Karim,6 Hervé Puy,6
Anne Sophie Alary,3 Sarah Ducamp,7 Frédérique Verdier,7 Cécile Bouilloux,1,2 Alice Rousseau,7 Marie-Christine Jacob,8 Agathe Debliquis,9
Agnes Charpentier,10 Emmanuel Gyan,11 Bruno Anglaret,12 Cecile Leyronnas,13 Selim Corm,14 Borhane Slama,15 Stephane Cheze,16 Kamel Laribi,17
Shanti Amé,18 Christian Rose,19 Florence Lachenal,20 Andrea Toma,21
Gian Matteo Pica,22 Martin Carre,1,2 Frédéric Garban,1,2 Clara Mariette,1,2 Jean-Yves Cahn,1,2 Mathieu Meunier,1,2 Olivier Herault,23 Pierre Fenaux,24 Orianne Wagner-Ballon,25 Valerie Bardet,26 Francois Dreyfus27
and Michaela Fontenay3
1Department of Hematology, CHU Grenoble-Alpes, Grenoble; 2Institute for Advanced Biosciences, INSERM U1209, CNRS UMR 5309, Grenoble; 3Assistance Publique- Hôpitaux de Paris (AP-HP), Service d’Hématologie Biologique, Hôpitaux Universitaires Paris Centre, Institut Cochin, Université Paris Descartes; 4SOL Hematology, Clinique Saint Anne, Strasbourg; 5Department of Hematology, Hôpital Emile Muller, CH de Mulhouse; 6INSERM UMR1149, CNRS 8252 - Centre de Recherche sur l'Inflammation (CRI) Equipe “Hème, Fer et Pathologies Inflammatoires”, Labex GREX, Centre Français des Porphyries - Hôpital Louis Mourier HUPNVS, Paris; 7Institut Cochin, INSERM U1016, CNRS UMR 8104, Paris Descartes University; 8Institut de Biologie et Pathologie, Immunology, CHU Grenoble-Alpes, Grenoble; 9Hematology Laboratory, Mulhouse Hospital; 10Department of Hematology, Hôpital St Philibert, Lille; 11Department of Hematology, CHU de Tours; 12CH de Valence; 13Institut Daniel Hollard, Grenoble; 14Medipole de Savoie, Challes les Eaux; 15Department of Hematology, CH d'Avignon; 16Department of Hematology, CHU Caen; 17Department of Hematology , CH Le Mans; 18Department of Hematology, Hôpital Civil, CHU Strasbourg; 19Department of Hematology, Hôpital Saint Vincent de Paul, Lille; 20Department of Hematology CH Pierre Oudot, Bourgoin-Jallieu; 21Department of Hematology, Hôpital Universitaire Henri Mondor, AP-HP, Université Paris 12, Créteil; 22Department of Hematology, CH Métropole Savoie, Chambery; 23Laboratoire d’Hématologie, CHU Tours; 24Department of Hematology, Saint Louis Hospital, AP-HP, Université Paris Diderot; 25Département d’Hématologie et Immunologie Biologiques, Hôpital Universitaire Henri Mondor, Creteil; 26Service d’Hématologie Immunologie Transfusion, Hôpitaux Universitaires Paris Ile de France-Ouest, AP-HP and 27Department of Hematology, Cochin Hospital, Paris V, France
ABSTRACT
Erythropoiesis-stimulating agents are generally the first line of treatment of anemia in patients with lower-risk myelodysplastic syndrome. We prospectively investigated the predictive value of somatic mutations, and biomarkers of ineffective erythropoiesis including the flow cytometry RED score, serum growth-differentia- tion factor-15, and hepcidin levels. Inclusion criteria were no prior treatment with erythropoiesis-stimulating agents, low- or intermedi- ate-1-risk myelodysplastic syndrome according to the International Prognostic Scoring System, and a hemoglobin level <10 g/dL. Patients could be red blood cell transfusion-dependent or not and were given epoetin zeta 40 000 IU/week. Serum erythropoietin level, iron param- eters, hepcidin, flow cytometry Ogata and RED scores, and growth- differentiation factor-15 levels were determined at baseline, and molecular analysis by next-generation sequencing was also conduct- ed. Erythroid response (defined according to the International Working Group 2006 criteria) was assessed at week 12. Seventy patients, with a median age of 78 years, were included in the study.
Correspondence:
SOPHIE PARK
spark@chu-grenoble.fr
Received: Juy 27, 2018. Accepted: October 2, 2018. Pre-published: October4,2018.
doi:10.3324/haematol.2018.203158
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haematologica | 2019; 104(3)
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