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Published in: European Journal of Medical Research 1/2023

Open Access 01-12-2023 | Myelodysplastic Syndrome | Research

The value of serum IL-4 to predict the survival of MDS patients

Authors: Zhaoyun Liu, Xintong Xu, Likun Zheng, Kai Ding, Chun Yang, Jincheng Huang, Rong Fu

Published in: European Journal of Medical Research | Issue 1/2023

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Abstract

Background

Immune indicators are routinely used for the detection of myelodysplastic syndrome (MDS), but these are not utilized as a reference indicator to assess prognosis in MDS-related prognostic evaluation systems, such as the World Health Organizational prognostic scoring system, the international prostate symptom score, and the revised international prostate symptom score.

Methods

We examined immune indicators, including cluster of differentiation (CD)3, CD4, CD8, CD56, CD19, interleukin (IL)-2, IL-4, IL-6, IL-10, tumor necrosis factor-a, and interferon-γ in 155 newly diagnosed MDS patients. We also conducted a correlation analysis with clinical indices.

Results

IL-4 was found to be a predictor of survival in these 155 patients using the receiver operating characteristic curve, with 5.155 as the cut-off point. Patients with serum IL-4 levels ≥ 5.155 had a lower overall survival (OS) than those with IL-45.155 at diagnosis. Furthermore, multivariate analysis revealed that IL-4 levels > 5.155 were an independent predictor of OS (hazard ratio: 0.237; 95% confidence interval, 0.114–0.779; P = 0.013). In addition, serum IL-4 expression in the three different scoring systems showed significant differences in the survival of medium- to high-risk MDS patients (P = 0.014, P < 0.001, P < 0.001).

Conclusions

According to our study, IL-4 levels at the time of diagnosis can predict MDS prognosis in patients as a simple index reflecting host systemic immunity.
Appendix
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Literature
1.
go back to reference Saygin C, Carraway HE. Current and emerging strategies for management of myelodysplastic syndromes. Blood Rev. 2021;48: 100791.CrossRef Saygin C, Carraway HE. Current and emerging strategies for management of myelodysplastic syndromes. Blood Rev. 2021;48: 100791.CrossRef
2.
go back to reference Cazzola M. Myelodysplastic syndromes. N Engl J Med. 2020;383(14):1358–74.CrossRef Cazzola M. Myelodysplastic syndromes. N Engl J Med. 2020;383(14):1358–74.CrossRef
3.
go back to reference Braun T, Fenaux P. Myelodysplastic syndromes (MDS) and autoimmune disorders (AD): cause or consequence? Best Pract Res Clin Haematol. 2013;26(4):327–36.CrossRef Braun T, Fenaux P. Myelodysplastic syndromes (MDS) and autoimmune disorders (AD): cause or consequence? Best Pract Res Clin Haematol. 2013;26(4):327–36.CrossRef
4.
go back to reference Parker JE, Mufti GJ, Rasool F, et al. The role of apoptosis, proliferation, and the Bcl-2-related proteins in the myelodysplastic syndromes and acute myeloid leukemia secondary to MDS. Blood. 2000;96(12):3932–8.CrossRef Parker JE, Mufti GJ, Rasool F, et al. The role of apoptosis, proliferation, and the Bcl-2-related proteins in the myelodysplastic syndromes and acute myeloid leukemia secondary to MDS. Blood. 2000;96(12):3932–8.CrossRef
5.
go back to reference Gañán-Gómez I, Wei Y, Starczynowski DT, et al. Deregulation of innate immune and inflammatory signaling in myelodysplastic syndromes. Leukemia. 2015;29(7):1458–69.CrossRef Gañán-Gómez I, Wei Y, Starczynowski DT, et al. Deregulation of innate immune and inflammatory signaling in myelodysplastic syndromes. Leukemia. 2015;29(7):1458–69.CrossRef
6.
go back to reference Mufti G, List AF, Gore SD, et al. Myelodysplastic syndrome. Hematology Am Soc Hematol Educ Program. 2003;2003:176–99.CrossRef Mufti G, List AF, Gore SD, et al. Myelodysplastic syndrome. Hematology Am Soc Hematol Educ Program. 2003;2003:176–99.CrossRef
7.
go back to reference Morrison SJ, Spradling AC. Stem cells and niches: mechanisms that promote stem cell maintenance throughout life. Cell. 2008;132(4):598–611.CrossRef Morrison SJ, Spradling AC. Stem cells and niches: mechanisms that promote stem cell maintenance throughout life. Cell. 2008;132(4):598–611.CrossRef
8.
go back to reference Schofield R. The relationship between the spleen colony-forming cell and the haemopoietic stem cell. Blood Cells. 1978;4(1–2):7–25. Schofield R. The relationship between the spleen colony-forming cell and the haemopoietic stem cell. Blood Cells. 1978;4(1–2):7–25.
9.
go back to reference De Wynter E, Allen T, Coutinho L, et al. Localisation of granulocyte macrophage colony-stimulating factor in human long-term bone marrow cultures. Biol Immunocytochem Charact J Cell Sci. 1993;106(Pt 3):761–9. De Wynter E, Allen T, Coutinho L, et al. Localisation of granulocyte macrophage colony-stimulating factor in human long-term bone marrow cultures. Biol Immunocytochem Charact J Cell Sci. 1993;106(Pt 3):761–9.
10.
go back to reference Tlsty TD, Coussens LM. Tumor stroma and regulation of cancer development. Annu Rev Pathol. 2006;1:119–50.CrossRef Tlsty TD, Coussens LM. Tumor stroma and regulation of cancer development. Annu Rev Pathol. 2006;1:119–50.CrossRef
11.
go back to reference Wang C, Yang Y, Gao S, et al. Immune dysregulation in myelodysplastic syndrome: clinical features, pathogenesis and therapeutic strategies. Crit Rev Oncol Hematol. 2018;122:123–32.CrossRef Wang C, Yang Y, Gao S, et al. Immune dysregulation in myelodysplastic syndrome: clinical features, pathogenesis and therapeutic strategies. Crit Rev Oncol Hematol. 2018;122:123–32.CrossRef
12.
go back to reference Della Porta MG, Tuechler H, Malcovati L, et al. Validation of WHO classification-based Prognostic Scoring System (WPSS) for myelodysplastic syndromes and comparison with the revised International Prognostic Scoring System (IPSS-R). A study of the International Working Group for Prognosis in Myelodysplasia (IWG-PM). Leukemia. 2015;29(7):1502–13.CrossRef Della Porta MG, Tuechler H, Malcovati L, et al. Validation of WHO classification-based Prognostic Scoring System (WPSS) for myelodysplastic syndromes and comparison with the revised International Prognostic Scoring System (IPSS-R). A study of the International Working Group for Prognosis in Myelodysplasia (IWG-PM). Leukemia. 2015;29(7):1502–13.CrossRef
13.
go back to reference Metze K, Reis-Alves SC, Lorand-Metze I. The World Health Organisation classification of myelodysplastic syndromes contains prognostically relevant information beyond the prognostic scores IPSS-R or WPSS. Eur J Cancer. 2017;72:266–8.CrossRef Metze K, Reis-Alves SC, Lorand-Metze I. The World Health Organisation classification of myelodysplastic syndromes contains prognostically relevant information beyond the prognostic scores IPSS-R or WPSS. Eur J Cancer. 2017;72:266–8.CrossRef
14.
go back to reference Bektaş Ö, Üner A, Eliaçık E, et al. Comparison of myelodysplastic syndrome prognostic scoring systems. Turk J Haematol. 2016;33(2):119–26.CrossRef Bektaş Ö, Üner A, Eliaçık E, et al. Comparison of myelodysplastic syndrome prognostic scoring systems. Turk J Haematol. 2016;33(2):119–26.CrossRef
15.
go back to reference Malcovati L, Nimer SD. Myelodysplastic syndromes: diagnosis and staging. Cancer Control. 2008;15(Suppl):4–13.CrossRef Malcovati L, Nimer SD. Myelodysplastic syndromes: diagnosis and staging. Cancer Control. 2008;15(Suppl):4–13.CrossRef
16.
go back to reference Hamdi W, Ogawara H, Handa H, et al. Clinical significance of Th1/Th2 ratio in patients with myelodysplastic syndrome. Int J Lab Hematol. 2009;31(6):630–8.CrossRef Hamdi W, Ogawara H, Handa H, et al. Clinical significance of Th1/Th2 ratio in patients with myelodysplastic syndrome. Int J Lab Hematol. 2009;31(6):630–8.CrossRef
17.
go back to reference Han D, Tao J, Fu R, et al. Myeloid-derived suppressor cell cytokine secretion as prognostic factor in myelodysplastic syndromes. Innate Immun. 2020;26(8):703–15.CrossRef Han D, Tao J, Fu R, et al. Myeloid-derived suppressor cell cytokine secretion as prognostic factor in myelodysplastic syndromes. Innate Immun. 2020;26(8):703–15.CrossRef
18.
go back to reference Lechner MG, Liebertz DJ, Epstein AL. Characterization of cytokine-induced myeloid-derived suppressor cells from normal human peripheral blood mononuclear cells. J Immunol. 2010;185(4):2273–84.CrossRef Lechner MG, Liebertz DJ, Epstein AL. Characterization of cytokine-induced myeloid-derived suppressor cells from normal human peripheral blood mononuclear cells. J Immunol. 2010;185(4):2273–84.CrossRef
19.
go back to reference Yang L, Mailloux A, Rollison DE, et al. Naive T-cells in myelodysplastic syndrome display intrinsic human telomerase reverse transcriptase (hTERT) deficiency. Leukemia. 2013;27(4):897–906.CrossRef Yang L, Mailloux A, Rollison DE, et al. Naive T-cells in myelodysplastic syndrome display intrinsic human telomerase reverse transcriptase (hTERT) deficiency. Leukemia. 2013;27(4):897–906.CrossRef
20.
go back to reference Kiladjian JJ, Bourgeois E, Lobe I, et al. Cytolytic function and survival of natural killer cells are severely altered in myelodysplastic syndromes. Leukemia. 2006;20(3):463–70.CrossRef Kiladjian JJ, Bourgeois E, Lobe I, et al. Cytolytic function and survival of natural killer cells are severely altered in myelodysplastic syndromes. Leukemia. 2006;20(3):463–70.CrossRef
21.
go back to reference Pizzi M, Boi M, Bertoni F, et al. Emerging therapies provide new opportunities to reshape the multifaceted interactions between the immune system and lymphoma cells. Leukemia. 2016;30(9):1805–15.CrossRef Pizzi M, Boi M, Bertoni F, et al. Emerging therapies provide new opportunities to reshape the multifaceted interactions between the immune system and lymphoma cells. Leukemia. 2016;30(9):1805–15.CrossRef
22.
go back to reference Che F, Heng X, Zhang H, et al. Novel B7-H4-mediated crosstalk between human non-Hodgkin lymphoma cells and tumor-associated macrophages leads to immune evasion via secretion of IL-6 and IL-10. Cancer Immunol Immunother. 2017;66(6):717–29.CrossRef Che F, Heng X, Zhang H, et al. Novel B7-H4-mediated crosstalk between human non-Hodgkin lymphoma cells and tumor-associated macrophages leads to immune evasion via secretion of IL-6 and IL-10. Cancer Immunol Immunother. 2017;66(6):717–29.CrossRef
23.
go back to reference Kawai T, Akira S. The role of pattern-recognition receptors in innate immunity: update on Toll-like receptors. Nat Immunol. 2010;11(5):373–84.CrossRef Kawai T, Akira S. The role of pattern-recognition receptors in innate immunity: update on Toll-like receptors. Nat Immunol. 2010;11(5):373–84.CrossRef
24.
go back to reference Starczynowski DT, Kuchenbauer F, Argiropoulos B, et al. Identification of miR-145 and miR-146a as mediators of the 5q-syndrome phenotype. Nat Med. 2010;16(1):49–58.CrossRef Starczynowski DT, Kuchenbauer F, Argiropoulos B, et al. Identification of miR-145 and miR-146a as mediators of the 5q-syndrome phenotype. Nat Med. 2010;16(1):49–58.CrossRef
25.
go back to reference Post SM, Quintás-Cardama A. Closing in on the pathogenesis of the 5q-syndrome. Expert Rev Anticancer Ther. 2010;10(5):655–8.CrossRef Post SM, Quintás-Cardama A. Closing in on the pathogenesis of the 5q-syndrome. Expert Rev Anticancer Ther. 2010;10(5):655–8.CrossRef
26.
go back to reference Pich A, Godio L, Riera L, et al. Myelodysplastic syndrome with del (5q) and JAK2(V617F) mutation transformed to acute myeloid leukaemia with complex karyotype. Ann Hematol. 2016;95(3):525–7.CrossRef Pich A, Godio L, Riera L, et al. Myelodysplastic syndrome with del (5q) and JAK2(V617F) mutation transformed to acute myeloid leukaemia with complex karyotype. Ann Hematol. 2016;95(3):525–7.CrossRef
27.
go back to reference Moh’d Al-Rawashdeh B, Sada Alhanjori A, Ali E, et al. Association of IL-4 polymorphisms with allergic rhinitis in Jordanian population. Medicina (Kaunas). 2020;56(4):1. Moh’d Al-Rawashdeh B, Sada Alhanjori A, Ali E, et al. Association of IL-4 polymorphisms with allergic rhinitis in Jordanian population. Medicina (Kaunas). 2020;56(4):1.
28.
go back to reference Vial T, Descotes J. Clinical toxicity of cytokines used as haemopoietic growth factors. Drug Saf. 1995;13(6):371–406.CrossRef Vial T, Descotes J. Clinical toxicity of cytokines used as haemopoietic growth factors. Drug Saf. 1995;13(6):371–406.CrossRef
29.
go back to reference Perrine SP, Vichinsky E, Faller DV. Hematopoietic hormones: from cloning to clinic. Am J Pediatr Hematol Oncol. 1989;11(3):268–75. Perrine SP, Vichinsky E, Faller DV. Hematopoietic hormones: from cloning to clinic. Am J Pediatr Hematol Oncol. 1989;11(3):268–75.
30.
go back to reference Wetzler M, Estrov Z, Talpaz M, et al. Leukemia inhibitory factor in long-term adherent layer cultures: increased levels of bioactive protein in leukemia and modulation by IL-4, IL-1 beta, and TNF-alpha. Cancer Res. 1994;54(7):1837–42. Wetzler M, Estrov Z, Talpaz M, et al. Leukemia inhibitory factor in long-term adherent layer cultures: increased levels of bioactive protein in leukemia and modulation by IL-4, IL-1 beta, and TNF-alpha. Cancer Res. 1994;54(7):1837–42.
31.
go back to reference Serio B, Selleri C, Maciejewski JP. Impact of immunogenetic polymorphisms in bone marrow failure syndromes. Mini Rev Med Chem. 2011;11(6):544–52.CrossRef Serio B, Selleri C, Maciejewski JP. Impact of immunogenetic polymorphisms in bone marrow failure syndromes. Mini Rev Med Chem. 2011;11(6):544–52.CrossRef
32.
go back to reference Schaefer EJ, Lindsley RC. Significance of clonal mutations in bone marrow failure and inherited myelodysplastic syndrome/acute myeloid leukemia predisposition syndromes. Hematol Oncol Clin North Am. 2018;32(4):643–55.CrossRef Schaefer EJ, Lindsley RC. Significance of clonal mutations in bone marrow failure and inherited myelodysplastic syndrome/acute myeloid leukemia predisposition syndromes. Hematol Oncol Clin North Am. 2018;32(4):643–55.CrossRef
33.
go back to reference Greenberger JS, Krensky AM, Messner H, et al. Production of colony-stimulating factor(s) for granulocyte-macrophage and multipotential (granulocyte/erythroid/megakaryocyte/macrophage) hematopoietic progenitor cells (CFU-GEMM) by clonal lines of human IL-2-dependent T-lymphocytes. Exp Hematol. 1984;12(9):720–7. Greenberger JS, Krensky AM, Messner H, et al. Production of colony-stimulating factor(s) for granulocyte-macrophage and multipotential (granulocyte/erythroid/megakaryocyte/macrophage) hematopoietic progenitor cells (CFU-GEMM) by clonal lines of human IL-2-dependent T-lymphocytes. Exp Hematol. 1984;12(9):720–7.
34.
go back to reference Lemoli RM, Fortuna A, Fogli M, et al. Proliferative response of human marrow myeloid progenitor cells to in vivo treatment with granulocyte colony-stimulating factor alone and in combination with interleukin-3 after autologous bone marrow transplantation. Exp Hematol. 1995;23(14):1520–6. Lemoli RM, Fortuna A, Fogli M, et al. Proliferative response of human marrow myeloid progenitor cells to in vivo treatment with granulocyte colony-stimulating factor alone and in combination with interleukin-3 after autologous bone marrow transplantation. Exp Hematol. 1995;23(14):1520–6.
35.
go back to reference Mehta HM, Malandra M, Corey SJ. G-CSF and GM-CSF in neutropenia. J Immunol. 2015;195(4):1341–9.CrossRef Mehta HM, Malandra M, Corey SJ. G-CSF and GM-CSF in neutropenia. J Immunol. 2015;195(4):1341–9.CrossRef
36.
go back to reference Achuthan AA, Lee KMC, Hamilton JA. Targeting GM-CSF in inflammatory and autoimmune disorders. Semin Immunol. 2021;54: 101523.CrossRef Achuthan AA, Lee KMC, Hamilton JA. Targeting GM-CSF in inflammatory and autoimmune disorders. Semin Immunol. 2021;54: 101523.CrossRef
37.
go back to reference Barreyro L, Will B, Bartholdy B, et al. Overexpression of IL-1 receptor accessory protein in stem and progenitor cells and outcome correlation in AML and MDS. Blood. 2012;120(6):1290–8.CrossRef Barreyro L, Will B, Bartholdy B, et al. Overexpression of IL-1 receptor accessory protein in stem and progenitor cells and outcome correlation in AML and MDS. Blood. 2012;120(6):1290–8.CrossRef
38.
go back to reference Pardanani A, Finke C, Lasho TL, et al. IPSS-independent prognostic value of plasma CXCL10, IL-7 and IL-6 levels in myelodysplastic syndromes. Leukemia. 2012;26(4):693–9.CrossRef Pardanani A, Finke C, Lasho TL, et al. IPSS-independent prognostic value of plasma CXCL10, IL-7 and IL-6 levels in myelodysplastic syndromes. Leukemia. 2012;26(4):693–9.CrossRef
39.
go back to reference Kitagawa M, Saito I, Kuwata T, et al. Overexpression of tumor necrosis factor (TNF)-alpha and interferon (IFN)-gamma by bone marrow cells from patients with myelodysplastic syndromes. Leukemia. 1997;11(12):2049–54.CrossRef Kitagawa M, Saito I, Kuwata T, et al. Overexpression of tumor necrosis factor (TNF)-alpha and interferon (IFN)-gamma by bone marrow cells from patients with myelodysplastic syndromes. Leukemia. 1997;11(12):2049–54.CrossRef
40.
go back to reference Aggarwal S, van de Loosdrecht AA, Alhan C, et al. Role of immune responses in the pathogenesis of low-risk MDS and high-risk MDS: implications for immunotherapy. Br J Haematol. 2011;153(5):568–81.CrossRef Aggarwal S, van de Loosdrecht AA, Alhan C, et al. Role of immune responses in the pathogenesis of low-risk MDS and high-risk MDS: implications for immunotherapy. Br J Haematol. 2011;153(5):568–81.CrossRef
41.
go back to reference Zhang Z, Li X, Guo J, et al. Interleukin-17 enhances the production of interferon-γ and tumour necrosis factor-α by bone marrow T lymphocytes from patients with lower risk myelodysplastic syndromes. Eur J Haematol. 2013;90(5):375–84.CrossRef Zhang Z, Li X, Guo J, et al. Interleukin-17 enhances the production of interferon-γ and tumour necrosis factor-α by bone marrow T lymphocytes from patients with lower risk myelodysplastic syndromes. Eur J Haematol. 2013;90(5):375–84.CrossRef
42.
go back to reference Shetty V, Mundle S, Alvi S, et al. Measurement of apoptosis, proliferation and three cytokines in 46 patients with myelodysplastic syndromes. Leuk Res. 1996;20(11–12):891–900.CrossRef Shetty V, Mundle S, Alvi S, et al. Measurement of apoptosis, proliferation and three cytokines in 46 patients with myelodysplastic syndromes. Leuk Res. 1996;20(11–12):891–900.CrossRef
43.
go back to reference Kordasti SY, Afzali B, Lim Z, et al. IL-17-producing CD4(+) T cells, pro-inflammatory cytokines and apoptosis are increased in low risk myelodysplastic syndrome. Br J Haematol. 2009;145(1):64–72.CrossRef Kordasti SY, Afzali B, Lim Z, et al. IL-17-producing CD4(+) T cells, pro-inflammatory cytokines and apoptosis are increased in low risk myelodysplastic syndrome. Br J Haematol. 2009;145(1):64–72.CrossRef
44.
go back to reference Ho IC, Miaw SC. Regulation of IL-4 expression in immunity and diseases. Adv Exp Med Biol. 2016;941:31–77.CrossRef Ho IC, Miaw SC. Regulation of IL-4 expression in immunity and diseases. Adv Exp Med Biol. 2016;941:31–77.CrossRef
45.
go back to reference Iwaszko M, Biały S, Bogunia-Kubik K. Significance of interleukin (IL)-4 and IL-13 in inflammatory arthritis. Cells. 2021;10(11):1.CrossRef Iwaszko M, Biały S, Bogunia-Kubik K. Significance of interleukin (IL)-4 and IL-13 in inflammatory arthritis. Cells. 2021;10(11):1.CrossRef
46.
go back to reference Matsunaga MC, Yamauchi PS. IL-4 and IL-13 inhibition in atopic dermatitis. J Drugs Dermatol. 2016;15(8):925–9. Matsunaga MC, Yamauchi PS. IL-4 and IL-13 inhibition in atopic dermatitis. J Drugs Dermatol. 2016;15(8):925–9.
47.
go back to reference Hahn M, Ghoreschi K. The role of IL-4 in psoriasis. Expert Rev Clin Immunol. 2017;13(3):171–3.CrossRef Hahn M, Ghoreschi K. The role of IL-4 in psoriasis. Expert Rev Clin Immunol. 2017;13(3):171–3.CrossRef
48.
go back to reference Stauder R, Valent P, Theurl I. Anemia at older age: etiologies, clinical implications, and management. Blood. 2018;131(5):505–14.CrossRef Stauder R, Valent P, Theurl I. Anemia at older age: etiologies, clinical implications, and management. Blood. 2018;131(5):505–14.CrossRef
49.
go back to reference Zhou T, Hasty P, Walter CA, et al. Myelodysplastic syndrome: an inability to appropriately respond to damaged DNA? Exp Hematol. 2013;41(8):665–74.CrossRef Zhou T, Hasty P, Walter CA, et al. Myelodysplastic syndrome: an inability to appropriately respond to damaged DNA? Exp Hematol. 2013;41(8):665–74.CrossRef
50.
go back to reference Erba HP. Recent progress in the treatment of myelodysplastic syndrome in adult patients. Curr Opin Oncol. 2003;15(1):1–9.CrossRef Erba HP. Recent progress in the treatment of myelodysplastic syndrome in adult patients. Curr Opin Oncol. 2003;15(1):1–9.CrossRef
51.
go back to reference Hulegårdh E, Nilsson C, Lazarevic V, et al. Characterization and prognostic features of secondary acute myeloid leukemia in a population-based setting: a report from the Swedish Acute Leukemia Registry. Am J Hematol. 2015;90(3):208–14.CrossRef Hulegårdh E, Nilsson C, Lazarevic V, et al. Characterization and prognostic features of secondary acute myeloid leukemia in a population-based setting: a report from the Swedish Acute Leukemia Registry. Am J Hematol. 2015;90(3):208–14.CrossRef
52.
go back to reference Menssen AJ, Walter MJ. Genetics of progression from MDS to secondary leukemia. Blood. 2020;136(1):50–60.CrossRef Menssen AJ, Walter MJ. Genetics of progression from MDS to secondary leukemia. Blood. 2020;136(1):50–60.CrossRef
53.
go back to reference Xie Z, Chen EC, Stahl M, et al. Prognostication in myelodysplastic syndromes (neoplasms): molecular risk stratification finally coming of age. Blood Rev. 2022;2022:101033.CrossRef Xie Z, Chen EC, Stahl M, et al. Prognostication in myelodysplastic syndromes (neoplasms): molecular risk stratification finally coming of age. Blood Rev. 2022;2022:101033.CrossRef
54.
go back to reference Kasprzak A, Nachtkamp K, Gattermann N, et al. Assessing the prognosis of patients with myelodysplastic syndromes (MDS). Cancers (Basel). 2022;14(8):1.CrossRef Kasprzak A, Nachtkamp K, Gattermann N, et al. Assessing the prognosis of patients with myelodysplastic syndromes (MDS). Cancers (Basel). 2022;14(8):1.CrossRef
55.
go back to reference Falantes JF, Márquez-Malaver FJ, Carrillo E, et al. SF3B1, RUNX1 and TP53 mutations significantly impact the outcome of patients with lower-risk myelodysplastic syndrome. Clin Lymphoma Myeloma Leuk. 2022;22(12):e1059–66.CrossRef Falantes JF, Márquez-Malaver FJ, Carrillo E, et al. SF3B1, RUNX1 and TP53 mutations significantly impact the outcome of patients with lower-risk myelodysplastic syndrome. Clin Lymphoma Myeloma Leuk. 2022;22(12):e1059–66.CrossRef
Metadata
Title
The value of serum IL-4 to predict the survival of MDS patients
Authors
Zhaoyun Liu
Xintong Xu
Likun Zheng
Kai Ding
Chun Yang
Jincheng Huang
Rong Fu
Publication date
01-12-2023
Publisher
BioMed Central
Published in
European Journal of Medical Research / Issue 1/2023
Electronic ISSN: 2047-783X
DOI
https://doi.org/10.1186/s40001-022-00948-w

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