Patients with low-risk myelodysplastic syndromes (LR-MDS) with bone marrow fibrosis (MF) display a cytokine pattern characterized by elevated interleukin 1β (IL-1β) and reduced interleukin 5 (IL-5), according to a presentation by Maria Stella Martino, MD, of the University of Florence in Italy and colleagues at the 2026 SOHO Annual Meeting.
The new findings support the characterization of fibrotic LR-MDS as an inflammation-driven “reactive” fibrosis rather than a distinct biological MDS subtype, according to the researchers.
The aim of the study was to characterize serum cytokine profiles to see whether serum cytokine profiles in fibrotic LR-MDS differed from those in nonfibrotic cases and to evaluate correlations with clinical outcomes. MF is associated with dismal outcomes and poor response to therapy in both high-risk and low-risk MDS.
The researchers assessed MF on trephine biopsy samples according to the European Consensus grading system. Patients were classified as fibrosis absent (MF0–1, n=77) or fibrosis present (MF≥2, n=10). Fourteen serum analytes (IL-1β, IL-2, IL-4, IL-5, IL-6, IL-7, IL-10, IL-13, IFN-γ, IFN-α, M-CSF, CCL3, CCL4, MIG/CXCL9) were measured in therapy-naive patients using the ELLA multiplex immunoassay platform (Bio-Techne).
Among the 14 analytes tested, two differed significantly. Serum IL-1β was higher in MF≥2 cases (median, 0.26 vs 0.00 pg/mL; P=0.004). IL-5 levels were higher in MF0–1 cases (median, 0.44 vs 0.22 pg/mL; P=0.019). The remaining 12 analytes showed no significant differences. No stimulation of eosinophilic lineage was observed.
“Patients with LR-MDS with MF display a cytokine pattern characterized by increased IL-1β and reduced IL-5, supporting inflammation-driven `reactive’ fibrosis rather than a distinct biological MDS subtype,” the authors wrote.
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