Inflammatory Cytokine Profiles and Treatment Response in Patients with Myelodysplastic Syndromes

Background Myelodysplastic syndromes (MDS) are clonal hematopoietic disorders characterized by ineffective hematopoiesis, cytopenia, and a variable risk of progression to acute myeloid leukemia. Increasing evidence suggests that immune dysregulation and chronic inflammation play an important role in MDS pathogenesis; however, the clinical relevance of inflammatory cytokine profiles in predicting treatment response remains insufficiently defined, particularly in Chinese patient populations Methods Myelodysplastic syndromes (MDS) are clonal hematopoietic disorders characterized by ineffective hematopoiesis, cytopenias, and a variable risk of progression to acute myeloid leukemia. Increasing evidence suggests that immune dysregulation and chronic inflammation play an important role in MDS pathogenesis; however, the clinical relevance of inflammatory cytokine profiles in predicting treatment response remains insufficiently defined, particularly in Chinese patient populations. Results A total of 186 patients were included. Elevated baseline levels of TNF-α and IL-6 were significantly associated with higher disease risk, increased bone marrow blast percentage, and inferior treatment response. Patients with lower TNF-α levels demonstrated significantly higher response rates compared with those with elevated TNF-α. High IL-6 expression was associated with reduced overall survival, with early and persistent separation of survival curves. In multivariable analyses, TNF-α and IL-6 remained independent predictors of treatment response after adjustment for age, disease risk category, and treatment modality. Conclusion Inflammatory cytokine profiles, particularly TNF-α and IL-6, are closely associated with treatment response, disease burden, and survival in Chinese patients with MDS. These findings support the clinical relevance of immune dysregulation in MDS and suggest that cytokine profiling may complement existing risk stratification models to guide more personalized therapeutic strategies. Keywords: Myelodysplastic syndromes; Inflammatory cytokines; TNF-α; IL-6; Treatment response