Alireza Rezvani - Department of Hematology, Medical Oncology and Stem Cell Transplantation, Hematology Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
Ahmad Monabati - Department of Pathology, Molecular Pathology and Cytogenetic Ward, Shiraz University of Medical Sciences, Shiraz, Iran
Zahra Kargar - Molecular Pathology and Cytogenetic Ward, Pathology Department, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
Akbar Safaie - Department of Molecular Pathology & Cytogenetics, Shiraz University of Medical Sciences, Shiraz, Iran
Mahdi Mahmoodzadeh - Department of Hematology, Isfahan University of Medical Sciences, Isfahan, Iran
Hamideh Moosapour - Evidence-Based Medicine Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
Marzieh Hosseini - Molecular Pathology and Cytogenetic Ward, Department of Pathology, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
Soleiman Kheiri - Department of Epidemiology and Biostatistics, School of Health, Modeling in Health Research Center, Shahrekord University of Medical Sciences, Shahrekord, Iran
Elham Taheri - Clinical and Anatomical Pathologist, Molecular Pathology and Cytogenetic Ward, Pathology Department, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran.

Background & Objective: Some of the patients with myelodysplastic syndrome (MDS) are categorized as good prognosis based on the Revised International Prognostic Scoring System (IPSS-R). However, these patients may have poor clinical outcomes. It seems that the current diagnostic tools and IPSS-R cannot consider genetic factors for determining the prognosis of MDS patients.Methods: This cross-sectional study included all adult MDS patients of both genders who were admitted from March ۲۰۱۵ to March ۲۰۲۰ to the Hematology wards of two educational tertiary hospitals in Iran (Namazi and Faghihi, affiliated with Shiraz University of Medical Sciences). Study data included relevant retrospective data from medical records and the results of immunohistochemical p۵۳ staining on bone marrow biopsies.Results: Of the ۸۴ patients, ۶۵ (۷۷.۴%) showed p۵۳ expression in bone marrow. They had shorter median survival than those without p۵۳ expression. Considering both variables of P۵۳ IHC results and IPSS-R score, the patients who died with low-risk IPSS-R score presented high p۵۳ expression.Conclusion: This study shows that the investigation of p۵۳ expression by IHC at the time of diagnosis is a valuable indicator of survival rate in MDS patients. These data suggest that the immunohistochemical analysis of p۵۳ can be a prognostic tool for MDS and should be used as an adjunct test to make decisions on the best therapeutic choice.

IHC, Myelodysplastic Syndrome, Prognosis, Tumor Suppressor Protein p۵۳