Receiver operating characteristics (ROCs) curve analysis for the diagnostic value of miR-21.

<p>The area under the ROC curve (AUC) was 0.648 (95% CI: 0.49 to 0.72).</p

Differences in baseline serum miR-21 expression levels.

<p>(A) Difference in serum miR-21 levels between healthy donors and patients with MDS prior to HMA therapy. Expression levels of serum miR-21 were normalized to the reference gene, miR-192, which was selected as described in Design and Methods. (B) Difference in baseline serum miR-21 levels between responders to HMA therapy and non-responders. Bar graph and whisker indicate the median value and standard deviation of serum miR-21 levels, respectively. Significance is indicated by the <i>P</i> value.</p

Overall characteristics of patients and stratification according to serum miR-21 level.

<p>Abbreviations: miR-21, microRNA-21; WHO, World Health Organization; RA, refractory anemia;</p><p>RARS, RA with ring sideroblasts; RCMD, refractory cytopenia with multilineage dysplasia; RCMD-RS, RCMD with ring sideroblasts; RAEB, refractory anemia with excess blasts; MDS-U, myelodysplastic syndromes unclassifiable; PB, peripheral blood; BM, bone marrow; HMA, hypomethylating agent; IPSS, International Prognostic Scoring System; NA, not available; WPSS, WHO classification-based Prognostic Scoring System; alloHCT, allogeneic hematopoietic stem cell transplant, INT, intermediate.</p>a<p>Cytogenetic: Good = normal, -Y alone, del(5q) alone, del(20q) alone; Poor = complex (≥3 abnormalities) or chromosome 7 anomalies; Intermediate = other abnormalities.</p>b<p>At least 2 units of red blood cell transfusion during 8 weeks prior to HMA initiation.</p

Kaplan-Meier curves for overall survival and progression-free survival comparisons.

<p>(A) Overall survival and (B) progression-free survival according to baseline serum miR-21 levels in patients with myelodysplastic syndromes treated with hypomethylating agents.</p

Multivariate analysis for overall response to HMA and progression-free survival.

<p>Abbreviations: ORR, overall response rate; PFS, progression-free survival; HR, hazard ratio; CI, confidence interval; IPSS, International Prognostic Scoring System; miR-21, microRNA-21.</p

Expression and stability of reference gene candidates in the sera of healthy donors and patients with MDS.

<p>(A) Quantification (Ct) of candidate reference miRNAs (miR-192, miR-16, and miR-93) in serum samples of healthy donors and MDS patients corrected for efficiency and two interpolate controls are shown. <i>Box plots</i> represent lower and upper quartiles with the median depicted with a horizontal line. Whiskers depict the 10th and 90th percentiles. Differences in serum levels of candidate miRNAs were not found between healthy donors (white box), MDS patients prior to HMA therapy (gray box), and MDS patients treated with four courses of HMA therapy (black box). (B) Average expression stability values for candidate reference miRs in MDS patients, which were calculated by the <i>geNorm</i> algorithm, are shown as a bar graph and with actual values. High expression stability is indicated by a low stability value. MDS, myelodysplastic syndromes; miRNAs, microRNAs; HMA, hypomethylating agents.</p

Univariate analysis for overall response rate, overall survival, and progression-free survival.

<p>Abbreviations: ORR, overall response rate; OS, overall survival; PFS, progression-free survival; RA, refractory anemia; RARS, RA with ring sideroblasts; RCMD, refractory cytopenia with multilineage dysplasia; RCMD-RS, RCMD with ring sideroblasts; RAEB, refractory anemia with excess blasts; MDS-U, myelodysplastic syndromes unclassifiable; IPSS, International Prognostic Scoring System; NA, not available; WPSS, WHO classification-based Prognostic Scoring System; RBC, red blood cell; alloHCT, allogeneic hematopoietic stem cell transplant; miR-21, microRNA-21.</p

Response to HMA therapy according to serum miR-21 level.

<p>Abbreviations: miR-21, microRNA-21; HMA, hypomethylating agent; IWG, International Working Group; CR, complete response; PR, partial response; mCR, marrow CR; SD, stable disease; HI, hematologic improvement; PD, progressive disease; ORR, overall response rate.</p><p>Results are shown as n (%) or median value.</p