Cytogenetic and cytokine profile in elderly patients with cytopenia

Abstract In the elderly with cytopenia, myelodysplastic syndrome (MDS) diagnosis may be missed. Cytokine levels contribute to the pathology of MDS. Hence, the objectives were to evaluate cytogenetic profile as a prognostic indicator as part of risk stratification and cytokine levels as a screening tool in patients with cytopenia for diagnosis. In two years (2016-2018), 150 elderly patients were screened. MDS diagnosis was confirmed by morphology. Interleukin-2 (IL2) and IL6 levels were assessed in 50 patients and karyotyping was performed in 20 confirmed cases of MDS. Age-matched healthy controls were used for comparison of cytokine levels. Among 150 patients, 88.6% patients had anemia, including nutritional anemia (51.2%). MDS diagnosis was confirmed in 35 patients. In 15 patients, unexplained cytopenia (UC) was present. Karyotyping in 20 MDS patients showed normal in 15 (75%), complex karyotype in 4 (20%) and double chromosomal abnormality in 1 (5%). The IPPS-R scoring showed 91% in the low risk group. 9% (n=3) in high-risk group which transformed to acute myeloid leukemia (AML) and 2 of them had 7q deletion. Among the 15 cases of UC, one patient died due to refractory anemia. No significant difference in levels of IL-2 and IL-6 were found between MDS and UC patients when compared to healthy controls, and also between different risk groups and karyotypes. A significant difference in IL2 levels was found in MDS patients with disease progression and with stable disease. Based on the findings, it is suggested that IL2 levels will help in predicting disease progression.