Prognostic significance of the red blood cell distribution width in diffuse large B-cell lymphoma patients

Shujuan Zhou, Fang Fang, Huiyao Chen, Wei Zhang, Yang Chen, Yifen Shi, Zhouyi Zheng, Yongyong Ma, Liyuan Tang, Jianhua Feng, Yu Zhang, Lan Sun, Yi Chen, Bin Liang, Kang Yu, Songfu Jiang, Shujuan Zhou, Fang Fang, Huiyao Chen, Wei Zhang, Yang Chen, Yifen Shi, Zhouyi Zheng, Yongyong Ma, Liyuan Tang, Jianhua Feng, Yu Zhang, Lan Sun, Yi Chen, Bin Liang, Kang Yu, Songfu Jiang

Abstract

This study examined the prognostic value of the baseline red blood cell distribution width (RDW) in diffuse large B cell lymphoma (DLBCL) patients. The associations between RDW and clinical characteristics were assessed in 161 DLBCL patients from 2005 to 2016. The log-rank test, univariate analysis, and Cox regression analysis were used to evaluate the relationship between RDW and survival. A RDW of 14.1% was considered to be the optimal cut-off value for predicting prognosis. A high RDW was associated with more frequent B symptoms (P=0.001), a higher International Prognostic Index score (P=0.032), more extranodal sites of disease (P=0.035), and significantly lower Eastern Cooperative Oncology Group performance status (P=0.031). The log-rank test demonstrated that patients with a high RDW had a shorter overall survival (OS) (2-year OS rate, 53.6% vs. 83.6%, P<0.001) and progression-free survival (PFS) (2-year PFS rate, 44.7% vs. 81.8%, P<0.001). The multivariate analysis demonstrated that RDW ≥14.1% was an independent predictor of OS (odds ratio [OR] = 0.345, P<0.001) and PFS (OR = 0.393, P=0.001). We demonstrated that a high RDW predicted an unfavorable prognosis in patients with DLBCL.

Keywords: diffuse large B cell lymphoma; prognosis; red blood cell distribution width; survival.

Conflict of interest statement

CONFLICTS OF INTEREST

The authors have no funding or conflicts of interest to disclose.

Figures

Figure 1. Receiver operating characteristic (ROC) curves…
Figure 1. Receiver operating characteristic (ROC) curves analysis for RDW
Figure 2. Kaplan-Meier survival analysis of RDW
Figure 2. Kaplan-Meier survival analysis of RDW
Overall survival (A) and progression-free survival (B) according to RDW in DLBCL patients.

References

    1. Habermann TM. New developments in the management of diffuse large B-cell lymphoma. Hematology. 2012;17(Suppl 1):S93–97.
    1. The International Non-Hodgkin's Lymphoma Prognostic Factors Project A predictive model for aggressive non-Hodgkin's lymphoma. N Engl J Med. 1993;329:987–994.
    1. Sehn LH, Berry B, Chhanabhai M, Fitzgerald C, Gill K, Hoskins P, Klasa R, Savage KJ, Shenkier T, Sutherland J, Gascoyne RD, Connors JM. The revised International Prognostic Index (R-IPI) is a better predictor of outcome than the standard IPI for patients with diffuse large B-cell lymphoma treated with R-CHOP. Blood. 2007;109:1857–1861.
    1. Mantovani A, Allavena P, Sica A, Balkwill F. Cancer-related inflammation. Nature. 2008;454:436–444.
    1. Hanahan D, Weinberg RA. Hallmarks of cancer: the next generation. Cell. 2011;144:646–674.
    1. Perisa V, Zibar L, Knezovic A, Perisa I, Sincic-Petricevic J, Aurer I. Prognostic nutritional index as a predictor of prognosis in patients with diffuse large B cell lymphoma. Wien Klin Wochenschr. 2016 Sep 8; Epub ahead of print.
    1. Forhecz Z, Gombos T, Borgulya G, Pozsonyi Z, Prohaszka Z, Janoskuti L. Red cell distribution width in heart failure: prediction of clinical events and relationship with markers of ineffective erythropoiesis, inflammation, renal function, and nutritional state. Am Heart J. 2009;158:659–666.
    1. Yesil A, Senates E, Bayoglu IV, Erdem ED, Demirtunc R, Kurdas Ovunc AO. Red cell distribution width: a novel marker of activity in inflammatory bowel disease. Gut Liver. 2011;5:460–467.
    1. Lippi G, Targher G, Montagnana M, Salvagno GL, Zoppini G, Guidi GC. Relation between red blood cell distribution width and inflammatory biomarkers in a large cohort of unselected outpatients. Arch Pathol Lab Med. 2009;133:628–632.
    1. Jo YH, Kim K, Lee JH, Kang C, Kim T, Park HM, Kang KW, Kim J, Rhee JE. Red cell distribution width is a prognostic factor in severe sepsis and septic shock. Am J Emerg Med. 2013;31:545–548.
    1. Grant BJ, Kudalkar DP, Muti P, McCann SE, Trevisan M, Freudenheim JL, Schunemann HJ. Relation between lung function and RBC distribution width in a population-based study. Chest. 2003;124:494–500.
    1. Perisa V, Zibar L, Sincic-Petricevic J, Knezovic A, Perisa I, Barbic J. Red blood cell distribution width as a simple negative prognostic factor in patients with diffuse large B-cell lymphoma: a retrospective study. Croat Med J. 2015;56:334–343.
    1. Koma Y, Onishi A, Matsuoka H, Oda N, Yokota N, Matsumoto Y, Koyama M, Okada N, Nakashima N, Masuya D, Yoshimatsu H, Suzuki Y. Increased red blood cell distribution width associates with cancer stage and prognosis in patients with lung cancer. PLoS One. 2013;8:e80240.
    1. Ay S, Eryilmaz MA, Aksoy N, Okus A, Unlu Y, Sevinc B. Is early detection of colon cancer possible with red blood cell distribution width? Asian Pac J Cancer Prev. 2015;16:753–756.
    1. Seretis C, Seretis F, Lagoudianakis E, Gemenetzis G, Salemis NS. Is red cell distribution width a novel biomarker of breast cancer activity? Data from a pilot study. J Clin Med Res. 2013;5:121–126.
    1. Riedl J, Posch F, Konigsbrugge O, Lotsch F, Reitter EM, Eigenbauer E, Marosi C, Schwarzinger I, Zielinski C, Pabinger I, Ay C. Red cell distribution width and other red blood cell parameters in patients with cancer: association with risk of venous thromboembolism and mortality. PLoS One. 2014;9:e111440.
    1. Albayrak S, Zengin K, Tanik S, Bakirtas H, Imamoglu A, Gurdal M. Red cell distribution width as a predictor of prostate cancer progression. Asian Pac J Cancer Prev. 2014;15:7781–7784.
    1. Weiss G, Goodnough LT. Anemia of chronic disease. N Engl J Med. 2005;352:1011–1023.
    1. Beyazit Y, Kekilli M, Ibis M, Kurt M, Sayilir A, Onal IK, Purnak T, Oztas E, Tas A, Yesil Y, Arhan M. Can red cell distribution width help to discriminate benign from malignant biliary obstruction? A retrospective single center analysis. Hepatogastroenterology. 2012;59:1469–1473.
    1. Baicus C, Caraiola S, Rimbas M, Patrascu R, Baicus A. for Grupul de Studiu al Scaderii Ponderale I. Utility of routine hematological and inflammation parameters for the diagnosis of cancer in involuntary weight loss. J Investig Med. 2011;59:951–955.
    1. Ozkalemkas F, Ali R, Ozkocaman V, Ozcelik T, Ozan U, Ozturk H, Kurt E, Evrensel T, Yerci O, Tunali A. The bone marrow aspirate and biopsy in the diagnosis of unsuspected nonhematologic malignancy: a clinical study of 19 cases. BMC Cancer. 2005;5:144.
    1. Spell DW, Jones DV, Jr, Harper WF, David Bessman J. The value of a complete blood count in predicting cancer of the colon. Cancer Detect Prev. 2004;28:37–42.
    1. Perlstein TS, Weuve J, Pfeffer MA, Beckman JA. Red blood cell distribution width and mortality risk in a community-based prospective cohort. Arch Intern Med. 2009;169:588–594.
    1. Patel KV, Ferrucci L, Ershler WB, Longo DL, Guralnik JM. Red blood cell distribution width and the risk of death in middle-aged and older adults. Arch Intern Med. 2009;169:515–523.
    1. Hu L, Li M, Ding Y, Pu L, Liu J, Xie J, Cabanero M, Li J, Xiang R, Xiong S. Prognostic value of RDW in cancers: a systematic review and meta-analysis. Oncotarget. 2016;8:16027–16035. doi: 10.18632/oncotarget.13784.
    1. Lee H, Kong SY, Sohn JY, Shim H, Youn HS, Lee S, Kim HJ, Eom HS. Elevated red blood cell distribution width as a simple prognostic factor in patients with symptomatic multiple myeloma. Biomed Res Int. 2014;2014:145619.
    1. Huang DP, Ma RM, Xiang YQ. Utility of Red Cell Distribution Width as a Prognostic Factor in Young Breast Cancer Patients. Medicine (Baltimore) 2016;95:e3430.
    1. Evans TC, Jehle D. The red blood cell distribution width. J Emerg Med. 1991;9(Suppl 1):71–74.
    1. Demirkol S, Balta S, Cakar M, Unlu M, Arslan Z, Kucuk U. Red cell distribution width: a novel inflammatory marker in clinical practice. Cardiol J. 2013;20:209.
    1. Sharma S, Nemeth E, Chen YH, Goodnough J, Huston A, Roodman GD, Ganz T, Lichtenstein A. Involvement of hepcidin in the anemia of multiple myeloma. Clin Cancer Res. 2008;14:3262–3267.
    1. Mbeunkui F, Johann DJ., Jr Cancer and the tumor microenvironment: a review of an essential relationship. Cancer Chemother Pharmacol. 2009;63:571–582.
    1. Cheson BD, Horning SJ, Coiffier B, Shipp MA, Fisher RI, Connors JM, Lister TA, Vose J, Grillo-Lopez A, Hagenbeek A, Cabanillas F, Klippensten D, Hiddemann W, et al. Report of an international workshop to standardize response criteria for non-Hodgkin's lymphomas. NCI Sponsored International Working Group. J Clin Oncol. 1999;17:1244.

Source: PubMed

Sponsorer og samarbejdspartnere

Medicinske tilstande

Narkotikainterventioner

3
Abonner