Figure 4 The altered iron metabolism after treatments with deferasirox (DFX) plus eltrombopag (ELT) in myelodysplastic syndrome (MDS) cells at 72 hours. (A) (a) RNA-sequence was performed on SKM-1 cells with DFX 40 µmol/L, ELT 40 µmol/L, or the two in combination at 72 hours. (b, c) Number of significantly different genes in each comparison group was shown. Compared with combination group, 1341 genes were upregulated, 9843 genes were downregulated. (d, e) GSEA functional gene analysis and differential gene expression analysis showed gene enrichments in iron metabolism–related signal pathway, which played important roles in inhibition of SKM-1 cells in combination group. (B, C) The iron metabolism–associated gene expression of TFRC was significantly upregulated in combination group, with significantly downregulated FTL. (D–G) The iron metabolism cell surface marker CD71 was significantly upregulated in the combination group, without affecting TPOR expression. Compared with the control group, * indicated p<0.05, ** indicated p<0.01, *** indicated p<0.001. Compared with the DFX group, # indicated p<0.05, ### indicated p<0.001. Compared with the ELT group, & indicated p<0.05, &&& indicated p<0.001.