Diagnostic Significance of Selected Plasma MicroRNAs in Myelodysplastic Syndromes

Myelodysplastic syndromes (MDSs) are clonal hematopoietic disorders characterized by ineffective hematopoiesis and their diagnosis remains challenging, requiring integration of clinical, morphological, and genetic data. MicroRNAs (miRNAs) have emerged as potential biomarkers in MDS, offering insights into disease mechanisms and patient stratification. This study aimed to evaluate the diagnostic and prognostic significance of five plasma microRNAs (miR-22-3p, miR-144-3p, miR-16-5p, let-7a-5p, and miR-451a) in 40 patients with MDS, diagnosed according to WHO 2016 criteria and stratified by R-IPSS, and ten healthy controls. Plasma miRNA levels were measured by RT-qPCR. Expression profiles were compared between patients and controls, and further assessed in relation to disease subtypes, risk categories, and clinicopathological features. Expression analysis showed that miR-144-3p, miR-16-5p, let-7a-5p, and miR-451a were significantly lower in MDS patients compared to controls. MiR-451a demonstrated the highest diagnostic predictive value (p = 0.0022), followed by miR-16-5p (p = 0.0055), miR-144-3p (p = 0.0074), and let-7a-5p (p = 0.0092). Let-7a-5p was higher in MDS with excess blasts and both let-7a-5p and miR-451a were lower in the low-risk R-IPSS group. Strong correlations between miR-16-5p, miR-144-3p, and miR-451a were observed, probably reflecting their function in erythropoiesis. None of the investigated microRNAs showed independent prognostic significance for overall survival. In conclusion, circulating microRNAs, particularly miR-451a and let-7a-5p, show promise as supportive biomarkers that may complement existing diagnostic and risk assessment tools in MDS. Further studies are needed to validate their clinical applicability.