The clinical and biologic significance of abnormal lipid profiles in patients with myelodysplastic syndromes

Serum lipid profiles were obtained in 108 patients with myelodysplastic syn drome (MDS) and compared to 28 healthy volunteers. Serum cholesterol and lo w-density and high-density lipoproteins (LDL and HDL) were found to be sign ificantly lower in MDS patients than in normals (p = 0.0001, 0.0038 and 0.0 37, respectively). This difference was significant for all MDS categories. Serum cholesterol and HDL were negatively related to biopsy cellularity (p = 0.001 and 0.0001, respectively), and serum triglycerides were negatively related to labeling index (p = 0.0003). No differences were noted in the li pid profiles of MDS patients with normal versus abnormal karyotypes. Howeve r, low-risk MDS patients with abnormal karyotypes had significantly lower t riglyceride levels compared with the high-risk patients (p = 0.027), as did low-risk patients with normal cytogenetics (p = 0.015). Serum HDL levels w ere significantly higher for the low-risk group with normal cytogenetics as well (p = 0.003). We conclude that serum cholesterol, LDL, and HDL are sig nificantly reduced in MDS patients, probably indicating excessive intracell ular lipid biosynthesis in the expanding clone. These relatively simple mea surements could serve as important prognostic markers and reliable indicato rs of disease activity in individual patients. Prospective studies to deter mine their utility as independent variables that guide the need for active therapeutic intervention are warranted.