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Increased parameters of oxidative stress and its relation to transfusion iron overload in patients with myelodysplastic syndromes
  1. Geane Felix de Souza1,
  2. Maritza Cavalcante Barbosa2,
  3. Talyta Ellen de Jesus Santos2,
  4. Teresa Maria de Jesus Ponte Carvalho2,
  5. Rivelilson Mendes de Freitas3,
  6. Manoel Ricardo Alves Martins4,
  7. Romélia Pinheiro Gonçalves2,
  8. Ronald Feitosa Pinheiro4,
  9. Silvia Maria Meira Magalhães4
  1. 1 Postgraduation Program in Medical Science, Federal University of Ceará, Fortaleza, CE, Brazil
  2. 2 Department of Clinical and Toxicological Analysis, Federal University of Ceará, Fortaleza, Brazil
  3. 3 Department of Pharmacy, Federal University of Piauí, Teresina, Brazil
  4. 4 Department of Clinical Medicine, Hematology Service, Federal University of Ceará, Fortaleza, CE, Brazil
  1. Correspondence to Dr Silvia Maria Meira Magalhães, R. Capitão Francisco Pedro,1290, Rodolfo Teófilo, Fortaleza, Ceará 60430370, Brazil; silviamm{at}

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Myelodysplastic syndromes (MDS) are group of stem cell disorders characterised by peripheral cytopaenias and a variable risk of progression to acute myeloid leukaemia. Most patients have anaemia and many develop transfusion dependence and iron overload (IOL), considered to be a negative independent prognostic factor associated with a higher risk of leukemic transformation and shorter survival.1

Iron pool is regarded as an important regulator of the production of reactive oxygen species (ROS). The excessive production of ROS and reactive nitrogen species causes lipid peroxidation, which can suppress self-renewal, the number of haematopoietic stem cells and directly induce DNA damage and genomic instability.2 However, the role of iron-mediated oxidative stress in the physiopathology of MDS remains uncertain.

The present study aimed to evaluate plasma nitrite (NO2 ) and plasma malonaldehyde, secondary product of lipid peroxidation, in patients with MDS and correlate them with IOL due to transfusion dependence in MDS patients.

Materials and methods

Consecutive adult patients with MDS with and without IOL, followed at the University Hospital of the Federal University of Ceará, Brazil, were enrolled. The study was approved by the local ethics committee (licence 150/2009). They were classified according to the presence or absence of IOL defined as serum ferritin of 1000 ng/ml or …

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  • Funding This work was supported by CAPES, CNPq and FUNCAP.

  • Contributors The following are employees of the laboratory of the Cancer Cytogenetics and Cytogenomics: GFdS, RFP, SMMM. The following are employees of the Department of Clinical and Toxicological Analyses: RPG, TMdJP, MCB, TEdJS. RMdF is a collaborator of the Department of Pharmacy. GFdS has a collection of biological samples from study participants after informed consent, conducted biochemical analyses and wrote the work; she is the guarantor. RFP, SMMM and MMRAM carried out the diagnosis of patients with MDS, interpreted the data and reviewed the manuscript. RPG, TMdJPC and RMdF were responsible for standardisation of techniques of oxidative stress, interpretation of data and reviewed the manuscript. MCB and TEJdS executed measurements of oxidative stress in all participants of the study and conducted statistical analysis.

  • Competing interests None.

  • Ethics approval The study was approved by the local ethics committee (licence 150/2009).

  • Provenance and peer review Not commissioned; externally peer reviewed.