Analysis of the Correlation Between MDS Inflammatory Indicators and Clinical Characteristics: A Comprehensive Analysis

Abstract

Objective: This study aims to investigate the correlations among the neutrophil-to-lymphocyte ratio (NLR), monocyte-to-lymphocyte ratio (MLR), and platelet-to-lymphocyte ratio (PLR) at the initial diagnosis of myelodysplastic syndrome (MDS) and the clinical characteristics of patients. It explores the correlation between MDS and inflammatory markers, providing a basis for early assessment of treatment efficacy, diagnosis, and guiding personalized treatment. Methods: Analyzing the bone marrow smears and flow cytometry immunophenotyping of 70 MDS patients. Conducting a comparative analysis of the multi-parameter linear correlation between the clinical characteristics of MDS patients and inflammatory markers, comparing the differences in inflammatory markers between MDS patients and the control group. Additionally, investigating the differential correlation analysis between different primitive cell ratios, different MDS types, different immunophenotypic characteristics, different morphological features, and inflammatory markers. Results: Comparative analysis between MDS and the control group revealed that NLR and PLR have good diagnostic specificity (area under the curve [AUC] = 0.9169, 0.8312). When comparing the clinical characteristics of MDS patients, MLR showed a strong correlation with the total white blood cell count at the initial diagnosis (r = 0.661, p = 0.0004), while NLR demonstrated a correlation with lactate dehydrogenase (LDH; r = 0.313, p = 0.037). In different WHO-classified MDS groups, there are significant differences in the comparison of three groups of inflammatory markers between the groups. The MDS group with specific immunophenotypic characteristics displayed significant differences in PLR compared to the group without specific immunophenotypic characteristics. Additionally, CD34 proportion exhibited a negative correlation with NLR index (r = -0.296, p = 0.0129). And patients with low PLR index have a higher survival time than those with high PLR index (p = 0.007). Conclusion: Inflammatory markers are correlated with the clinical characteristics of MDS, providing not only auxiliary evidence for the clinical diagnosis of MDS but also showing differences in inflammatory markers based on different tumor burdens in MDS. This serves as a reference for the treatment strategy of inhibiting the progression of MDS to acute leukemia by reversing the inflammatory trend.

Keywords: CD34; inflammatory markers; monocyte/lymphocyte ratio; myelodysplastic syndrome; neutrophil/lymphocyte ratio; platelet/lymphocyte ratio.

Figure 1

Specific immunophenotypes of MDS patients. (A) Loss of CD38 expression in original cells and (B) CD7 expression in original cells.

Figure 2

The intracytoplasmic particles of neutrophils decreased in MDS patients.

Figure 3

Analysis of inflammation index of MDS patients and ROC curve of control group at first diagnosis. (A) NLR, (B) MLR, and (C) PLR.

Figure 4

Correlation analysis of inflammation index and clinical index in MDS patients.

Figure 5

Differences in inflammation markers between different MDS subtypes: (A) NLR, (B) MLR, and (C) PLR. ⁣^∗∗p < 0.01; ⁣^∗∗∗p < 0.001; ⁣^∗∗∗∗p < 0.0001.

Figure 6

The difference of inflammatory markers in MDS group with neutropenia. (A) NLR, (B) MLR, and (C) PLR. ns: p > 0.05; ⁣^∗p < 0.05; ⁣^∗∗p < 0.01; ⁣^∗∗∗∗p < 0.0001.

Figure 7

The difference of inflammatory markers in MDS group with special immunophenotype. (A) NLR, (B) MLR, and (C) PLR. ns: p > 0.05; ⁣^∗p < 0.05; ⁣^∗∗∗p < 0.001; ⁣^∗∗∗∗p < 0.0001.

Figure 8

Correlation analysis of CD34+ percentage and inflammation index in MDS patients. (A) NLR, (B) MLR, and (C) PLR.

Figure 9

Correlation between MDS patient clinical outcomes and inflammation markers. (A) NLR, (B) MLR, and (C) PLR.