Objective To investigate the value of serum lactate dehydrogenase (LDH), β₂-microglobulin (β₂-MG) and serum ferritin (SF) combined with the modified WHO-based Prognostic Scoring System (WPSS) score in predicting poor prognosis of patients with myelodysplastic syndrome (MDS).

Methods A total of 110 patients with MDS were selected as the research objects, and serum levels of LDH, β₂-MG and SF were detected. The patients were divided into death group and survival group according to their survival status, and the serum levels of LDH, β₂-MG and SF as well as the modified WPSS score were compared between the two groups. The risk factors for poor prognosis in MDS patients and the predictive values of serum LDH, β₂-MG, SF and modified WPSS score alone and their combination for poor prognosis in MDS patients were analyzed.

Results The incidence of poor prognosis in MDS patients was 40.20% (41/102). The serum levels of LDH, β₂-MG and SF, the modified WPSS score, and the ratio of adverse karyotype prognosis in the death group were significantly higher than those in the survival group (P < 0.05). The results of Cox regression model analysis showed that elevated serum levels of LDH, β₂-MG and SF, elevated modified WPSS score, and adverse karyotype prognosis were risk factors for poor prognosis in MDS patients (P < 0.05). The results of receiver operating characteristic (ROC) curve analysis showed that the combination of serum LDH, β₂-MG, SF levels and modified WPSS score had a sensitivity of 95.12% and an area under the curve (AUC) of 0.918 for predicting poor prognosis in MDS patients, which were significantly higher than those of each indicator alone (P < 0.05).

Conclusion Serum LDH, β₂-MG, SF levels and modified WPSS score have certain predictive value for poor prognosis in MDS patients, but the combined prediction value of the four indicators is higher.