Diagnostic Potential of miR‑451a in Myelodysplastic Syndromes

Introduction:Myelodysplastic syndromes (MDS) are a group of clonal hematopoietic disorders characterized by ineffective hematopoiesis and a risk of progression to acute myeloid leukemia. Diagnosis often requires integrating clinical, morphological, and genetic data, but distinguishing MDS from overlapping conditions remains challenging. MiR-451a plays a crucial role in erythropoiesis and has shown potential as a diagnostic biomarker, though existing data on its expression in MDS are conflicting. Aim:The aim of the study is to evaluate miR-451a expression levels in MDS patients and healthy controls and to assess variations in expression among different MDS subgroups. Materials and Methods: Plasma samples from 40 MDS patients and 10 healthy controls were analyzed for the expression levels of miR-451a using quantitative real-time PCR (qPCR). Statistical analysis was performed to compare expression levels between the groups. Results:MiR-451a levels were significantly lower in MDS patients compared to healthy controls (median 0.8215 vs. 2.132; p < 0.0001). ROC analysis revealed high diagnostic accuracy (AUC = 0.9175), with a threshold of 1.161 providing 70.0% sensitivity and 100.0% specificity. Additionally, miR-451a levels were significantly lower in low-risk MDS patients compared to high-risk patients (p = 0.0449). A moderate positive correlation was observed between miR-451a and ferritin (p < 0.05), suggesting a link with iron metabolism. Conclusion:Our findings demonstrate that miR-451a is significantly downregulated in MDS patients, highlighting its potential as a diagnostic biomarker. While its prognostic utility remains uncertain, miR-451a shows promise for non-invasive diagnosis.