{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,9]],"date-time":"2026-04-09T18:04:17Z","timestamp":1775757857976,"version":"3.50.1"},"reference-count":43,"publisher":"Springer Science and Business Media LLC","issue":"4","license":[{"start":{"date-parts":[[2026,4,9]],"date-time":"2026-04-09T00:00:00Z","timestamp":1775692800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2026,4,9]],"date-time":"2026-04-09T00:00:00Z","timestamp":1775692800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"name":"Herzzentrum G\u00f6ttingen"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["J Cancer Res Clin Oncol"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Purpose<\/jats:title>\n                    <jats:p>Serum ferritin is an independent prognostic marker in myelodysplastic neoplasms (MDS) and serves as a surrogate parameter for iron overload. Oxidative stress derived from iron overload may induce genomic damage, thereby promoting genetic instability and disease progression in MDS. We aimed to evaluate a possible association between iron overload via serum ferritin and various parameters for genetic instability in MDS.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Fifty-one patients with confirmed MDS were analyzed and divided into three groups based on ferritin levels: non-elevated (\u2264\u2009275\u00a0\u00b5g\/L), moderately elevated (&gt;\u2009275 and\u2009&lt;\u20091000\u00a0\u00b5g\/L), and highly elevated (\u2265\u20091000\u00a0\u00b5g\/L). Genetic instability was assessed by cytogenetic analysis and somatic mutation profiling. DNA double-strand breaks were quantified by \u03b3H2AX-foci in CD34+\u2009peripheral blood cells, and telomere length was measured by flow-FISH.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Elevated serum ferritin was associated with increased cytogenetic abnormalities and somatic mutations at genomic regions commonly involved in MDS, higher levels of double-strand breaks, and shortened telomeres in granulocytes but not in lymphocytes. Markers of early-stage genetic instability, such as double-strand breaks and telomere shortening in granulocytes, were detectable at moderately elevated ferritin\u2009&gt;\u2009275\u00a0\u00b5g\/L, whereas markers for advanced-stage genetic aberrations, including somatic mutations and cytogenetic aberrations, were more prominent at ferritin levels\u2009\u2265\u20091000\u00a0\u00b5g\/L.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>These findings support the hypothesis that iron overload, reflected by elevated ferritin as surrogate parameter, may contribute to and\/or increase genetic instability in MDS patients with ineffective hematopoiesis. Notably, correlations were observed at ferritin levels below current thresholds for initiating iron chelation therapy, indicating clinical relevance early in the disease course.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s00432-026-06457-1","type":"journal-article","created":{"date-parts":[[2026,4,9]],"date-time":"2026-04-09T17:13:15Z","timestamp":1775754795000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["High serum ferritin is associated with genetic instability in myelodysplastic neoplasms"],"prefix":"10.1007","volume":"152","author":[{"given":"Christina","family":"Ganster","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hannes","family":"Treiber","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gina","family":"Westhofen","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Fabian","family":"Beier","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tienush","family":"Rassaf","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Haifa Kathrin","family":"Al-Ali","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Reingard","family":"Stuhlmann","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bertram","family":"Glass","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ulrike","family":"Bacher","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Katayoon","family":"Shirneshan","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tim H.","family":"Br\u00fcmmendorf","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ulrich","family":"Germing","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Norbert","family":"Gattermann","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Detlef","family":"Haase","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2026,4,9]]},"reference":[{"key":"6457_CR1","doi-asserted-by":"publisher","first-page":"513","DOI":"10.7326\/m19-0916","volume":"172","author":"E Angelucci","year":"2020","unstructured":"Angelucci E, Li J, Greenberg P et al (2020) Iron chelation in transfusion-dependent patients with low- to intermediate-1\u2013risk myelodysplastic syndromes: a randomized trial. 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