Different Inflammatory Profiles Associated with Low-risk MDS

A 2025 ASH study assessed 36 serum inflammatory markers in 95 patients with lower‑risk Myelodysplastic Syndromes (LR‑MDS) to define biologic subgroups. They identified five clusters with distinct inflammatory signatures; those with either very high inflammation (cluster C2) or very low inflammation (clusters C1 and C3) had poor or short‑lived responses to Erythropoiesis‑stimulating agents (ESAs), whereas clusters C4 and C5 had longer ESA response duration. Importantly, cluster C2 (high inflammation) also showed a higher rate of progression to leukemia compared with other groups. These findings support using baseline inflammatory profiling to predict ESA response and guide individualized therapy in LR‑MDS.