The Role of Inflammation and Nutrition-Based Scoring in Low-Risk Myelodysplastic Syndrome

Abstract While the pathogenesis of Myelodysplastic Syndrome (MDS) is diverse, growing evidence suggests that inflammation significantly influences disease development and progression. This study sought to assess the impact of inflammation and nutritional status on mortality, with a particular focus on patients with low-risk MDS. A retrospective analysis was conducted on 175 newly diagnosed low-risk MDS patients. A low Prognostic Nutritional Index (PNI) was significantly associated with poorer prognosis (p<0.001). The optimal PNI cut-off value for predicting mortality was identified as 47.47. Based on this cut-off, 92 patients had a low PNI score while 83 patients had a high PNI score. The comparison between these groups revealed a statistically significant difference in median overall survival (OS), with 45.5 months for the low PNI group and 75.1 months for the high PNI group (p<0.001). In the multivariate OS analysis, several factors were identified as independent predictors of prognosis, including a high Revised International Prognostic Scoring System (R-IPSS) score, low PNI, high systemic oxidative stress (SOS) score, advanced age, male gender, and transformation to acute myeloid leukemia. The PNI is a readily available and cost-effective marker that can be utilized to predict prognosis in patients with low-risk MDS.