Prognostic implications of low transferrin saturation in patients with primary myelofibrosis

Abstract Objectives Transferrin saturation (TSAT) 20% or less is considered to represent functional iron deficiency in the context of malignant disease, phenomenon mediated through inflammatory changes of iron homeostasis. We aimed to investigate clinical and prognostic significance of low TSAT in patients with primary (PMF) and secondary myelofibrosis (SMF), malignant diseases characterized by strong inflammatory milieu. Methods We retrospectively analyzed 87 patients with myelofibrosis and compared TSAT with disease specific parameters. Results One-third of patients had TSAT ≤20%. Lower TSAT was significantly associated with Janus-kinase-2 ( JAK2 ) mutation (P = 0.007), transfusion independency (P = 0.003), higher platelets (P = 0.004), lower mean-corpuscular-volume (P  Conclusions Low TSAT has detrimental effect on survival of PMF patients. This effect is independent of anemia and of ferritin levels that seem to be better at representing iron overload in PMF patients.