In patients with high-risk myelodysplastic syndromes (MDS), S100 calcium-binding protein A6 (S100A6) may be a potential marker of CD34+ cells, according to findings from a study published in the journal Heliyon.

Although treatment with azacitidine, decitabine, and hematopoietic stem cell transplantation have attained a degree of efficacy among individuals with MDS, high rates of mortality continue due to the heterogeneity of the disease and the lack of specificity in treatment. This, in turn, impacts survival rates and prognoses of patients with the disorder.

The researchers sought to explore the expression of S100A6 in CD34+ cells, along with the association between S100A6 expression and apoptosis of CD34+ cells, among high-risk patients with MDS. The current study was carried out in an effort to provide a new research direction for assessing the pathogenesis and prognosis of MDS.

S100A6, a member of the S100 protein family, exerts various biological functions via its interaction with target proteins and calcium ions. In the present study, the investigators detected S100A6 expression in bone marrow CD34+ cells obtained from high-risk patients with MDS.

Read more about experimental therapies for patients with MDS

Thirty seven patients—25 men and 12 women—with high-risk MDS who had been admitted to the Hematology Department of Tianjin Medical University General Hospital, Tianjin, China, between October 2020 and October 2022 participated in the study. The median participant age was 68 years (range, 40-84 years). A normal control group comprised 7 men and 25 women. The median age of the controls was 51 years (range, 18-80 years).

Bone marrow samples were obtained from all patients and controls, which were then diluted with phosphate-buffered saline. S100A6 mRNA expression in bone marrow CD34+ cells was measured with the use of real-time polymerase chain reaction (RT-PCR). Flow cytometry was used to study S100A6 expression in CD34+ cells.

Results of the study showed that per RT-PCR, significantly increased S100A6 mRNA expression was observed in the CD34+ cells of high-risk patients with MDS compared with the controls (1.05±0.69 vs 0.17±0.12, respectively; P <.01). In addition, with the use of flow cytometry, the expression of S100A6 in CD34+ cells was significantly higher in the MDS than in the control group (58.40±13.18 vs 45.83±15.01, respectively; P <.01).

Further, in high-risk patients with MDS, the total apoptosis rate of CD34+ cells was negatively correlated with S100A6 expression (r = −0.75; P <.01).

“Collectively, S100A6 may be a potential marker of CD34+ cells in high-risk patients with MDS and may participate in the [pathologic] behaviors of CD34+ cells, such as evasion of apoptosis,” the researchers explained. “Thus, S100A6 may be a potential target for eliminating minimal residual disease,” they concluded.


Zhai Y, Meng F, Li J, Ma J, Shen L, Zhang S. Upregulation of S100A6 and its relation with CD34+ cells apoptosis in high-risk myelodysplastic syndromes patients. Heliyon. Published online August 5, 2023. doi:10.1016/j.heliyon.2023.e18947