{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,4]],"date-time":"2026-08-04T15:03:39Z","timestamp":1785855819328,"version":"3.56.0"},"reference-count":22,"publisher":"Wiley","issue":"15","license":[{"start":{"date-parts":[[2025,8,4]],"date-time":"2025-08-04T00:00:00Z","timestamp":1754265600000},"content-version":"vor","delay-in-days":3,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2025,8,1]],"date-time":"2025-08-01T00:00:00Z","timestamp":1754006400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Cancer Medicine"],"published-print":{"date-parts":[[2025,8]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Myelodysplastic syndromes (MDS) encompass a heterogeneous group of haematological neoplasms characterized by ineffective haematopoiesis and a variable risk of transformation to acute myeloid leukaemia (AML). Elevated serum ferritin (SF), a marker of iron overload (IO), has been linked to poorer outcomes in MDS. However, the impact of pre\u2010treatment SF levels on azacytidine (AZA) response and survival outcomes remains unclear.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This retrospective cohort study included patients with World Health Organization\u2010defined MDS or AML with 20%\u201330% bone marrow blasts treated with AZA at the Virgen de la Victoria University Hospital (M\u00e1laga, Spain) from 2007 onwards. Patients were stratified into three groups based on pre\u2010treatment SF levels: &lt;\u2009500\u2009ng\/mL, 500\u20131000\u2009ng\/mL and &gt;\u20091000\u2009ng\/mL. Logistic regression and Kaplan\u2013Meier methods were used to analyse overall response (OR) and overall survival (OS).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Among 240 patients, 190 with available SF data were analysed. Patients with SF &gt;\u20091000\u2009ng\/mL showed significantly lower OR (24.2%) and shorter OS (median: 10.1\u2009months) compared to those with SF &lt;\u2009500\u2009ng\/mL (OR: 71.4%, OS: 18.2\u2009months) and 500\u20131000\u2009ng\/mL (OR: 82.6%, OS: 20.5\u2009months) (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.0001 for OR,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.001 for OS). Multivariate analysis confirmed elevated SF as an independent predictor of poorer outcomes.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Elevated pre\u2010treatment SF levels are strongly associated with reduced response and survival in patients with MDS or AML treated with AZA. Early IO management, such as iron chelation, may improve treatment outcomes.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/cam4.71127","type":"journal-article","created":{"date-parts":[[2025,8,4]],"date-time":"2025-08-04T07:21:37Z","timestamp":1754292097000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Impact of Pre\u2010Treatment Serum Ferritin on Response and Survival in Myelodysplastic Syndromes Treated With Azacytidine: A Multivariate Analysis"],"prefix":"10.1002","volume":"14","author":[{"given":"Gloria Moreno","family":"Carrasco","sequence":"first","affiliation":[{"name":"UGC Hematolog\u00eda y Hemoterapia Hospital Universitario Virgen de la Victoria  M\u00e1laga Spain"},{"name":"BE21\u2010Hematolog\u00eda e Inmunoterapia Instituto de Investigaci\u00f3n Biom\u00e9dica de M\u00e1laga y Plataforma en Nanomedicina (IBIMA Plataforma BIONAND)  M\u00e1laga Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4509-0161","authenticated-orcid":false,"given":"Rodolfo Matias Ortiz","family":"Flores","sequence":"additional","affiliation":[{"name":"BE21\u2010Hematolog\u00eda e Inmunoterapia Instituto de Investigaci\u00f3n Biom\u00e9dica de M\u00e1laga y Plataforma en Nanomedicina (IBIMA Plataforma BIONAND)  M\u00e1laga Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Regina Garc\u00eda","family":"Delgado","sequence":"additional","affiliation":[{"name":"UGC Hematolog\u00eda y Hemoterapia Hospital Universitario Virgen de la Victoria  M\u00e1laga Spain"},{"name":"BE21\u2010Hematolog\u00eda e Inmunoterapia Instituto de Investigaci\u00f3n Biom\u00e9dica de M\u00e1laga y Plataforma en Nanomedicina (IBIMA Plataforma BIONAND)  M\u00e1laga Spain"},{"name":"Departamento de Fisiolog\u00eda Humana, Histolog\u00eda Humana, Anatom\u00eda Patol\u00f3gica y Educaci\u00f3n F\u00edsico\u2010Deportiva, Facultad de Medicina Universidad de M\u00e1laga  M\u00e1laga Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Borja Cidoncha","family":"Morcillo","sequence":"additional","affiliation":[{"name":"UGC Hematolog\u00eda y Hemoterapia Hospital Universitario Virgen de la Victoria  M\u00e1laga Spain"},{"name":"BE21\u2010Hematolog\u00eda e Inmunoterapia Instituto de Investigaci\u00f3n Biom\u00e9dica de M\u00e1laga y Plataforma en Nanomedicina (IBIMA Plataforma BIONAND)  M\u00e1laga Spain"},{"name":"Departamento de Fisiolog\u00eda Humana, Histolog\u00eda Humana, Anatom\u00eda Patol\u00f3gica y Educaci\u00f3n F\u00edsico\u2010Deportiva, Facultad de Medicina Universidad de M\u00e1laga  M\u00e1laga Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ana Isabel","family":"Rosell Mas","sequence":"additional","affiliation":[{"name":"UGC Hematolog\u00eda y Hemoterapia Hospital Universitario Virgen de la Victoria  M\u00e1laga Spain"},{"name":"BE21\u2010Hematolog\u00eda e Inmunoterapia Instituto de Investigaci\u00f3n Biom\u00e9dica de M\u00e1laga y Plataforma en Nanomedicina (IBIMA Plataforma BIONAND)  M\u00e1laga Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dana","family":"D\u00edaz Canales","sequence":"additional","affiliation":[{"name":"UGC Hematolog\u00eda y Hemoterapia Hospital Universitario Virgen de la Victoria  M\u00e1laga Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mar\u00eda Rodr\u00edguez","family":"Gonz\u00e1lez","sequence":"additional","affiliation":[{"name":"UGC Hematolog\u00eda y Hemoterapia Hospital Universitario Virgen de la Victoria  M\u00e1laga Spain"},{"name":"BE21\u2010Hematolog\u00eda e Inmunoterapia Instituto de Investigaci\u00f3n Biom\u00e9dica de M\u00e1laga y Plataforma en Nanomedicina (IBIMA Plataforma BIONAND)  M\u00e1laga Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Manuel Carrasco","family":"Gomariz","sequence":"additional","affiliation":[{"name":"BE21\u2010Hematolog\u00eda e Inmunoterapia Instituto de Investigaci\u00f3n Biom\u00e9dica de M\u00e1laga y Plataforma en Nanomedicina (IBIMA Plataforma BIONAND)  M\u00e1laga Spain"},{"name":"UGC Farmacia Hospital Universitario Virgen de la Victoria  M\u00e1laga Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9135-5330","authenticated-orcid":false,"given":"Alejandro","family":"Escamilla\u2010S\u00e1nchez","sequence":"additional","affiliation":[{"name":"BE21\u2010Hematolog\u00eda e Inmunoterapia Instituto de Investigaci\u00f3n Biom\u00e9dica de M\u00e1laga y Plataforma en Nanomedicina (IBIMA Plataforma BIONAND)  M\u00e1laga Spain"},{"name":"Departamento de Fisiolog\u00eda Humana, Histolog\u00eda Humana, Anatom\u00eda Patol\u00f3gica y Educaci\u00f3n F\u00edsico\u2010Deportiva, Facultad de Medicina Universidad de M\u00e1laga  M\u00e1laga 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