ox-mtDNA is elevated in PB plasma from patients with MDS. (A) DNA isolated from PB plasma of MDS patients was amplified with nuclear or mitochondrial primers demonstrating that cell-free DNA is of mitochondrial origin. Representative image of 8 independent MDS samples. Log₁₀-transformed, glucose-adjusted levels of ox-mtDNA in PB and BM plasma from patients with MDS (B), and correlation with PB and BM within a given MDS sample (C; shading is 95% confidence bands for the linear regression), and in patients compared with controls in both discovery and validation sets (D-E). Box and whisker plots denoting median and variability outside the lower and upper bound. (F) ROC/AUC analyses of ox-mtDNA in patients with MDS compared with healthy controls. Log₁₀-transformed, glucose-adjusted levels of ox-mtDNA stratified by number of severe cytopenias (0-4) (G) (white blood cell [WBC] count, <5 × 10⁴; absolute neutrophil count [ANC], <0.80 × 10⁹/L; hemoglobin [HgB], <10 g/dL; platelets, <100 × 10⁹/L) and severity of BM fibrosis (H). Mean ± SEM. Df, dilution factor.