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Chen X, Liu J, Duan J, Xiong H, Liu Y, Zhang X, Huang C. Is RDW a clinically relevant prognostic factor for newly diagnosed multiple myeloma? A systematic review and meta-analysis. BMC Cancer 2022; 22:796. [PMID: 35854269 PMCID: PMC9297629 DOI: 10.1186/s12885-022-09902-9] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2022] [Accepted: 07/14/2022] [Indexed: 11/18/2022] Open
Abstract
Background Multiple myeloma (MM) is an incurable plasma cell malignancy. Red cell distribution width (RDW) is a prognostic marker in various diseases, solid tumors, and hematologic neoplasms, but its prognostic significance in MM is controversial. In this study, we aimed to assess the relationship between RDW and the clinical prognosis of MM patients through a meta-analysis. Methods Relevant literature were retrieved from PubMed, Embase, and Web of Science databases according to PRISMA guideline. All relevant parameters were extracted and combined for statistical analysis. The effect size was presented as hazard ratio (HR)/odds ratio (OR) and 95% confidence interval (CI). HR/OR > 1 in MM patients with high RDW suggested a worse prognosis. Heterogeneity test evaluation was performed using Cochran's Q test and I2 statistics. A Pheterogeneity < 0.10 or I2 > 50% suggested significant heterogeneity. P < 0.05 was considered statistically significant. Statistical analysis was performed using Stata 12.0 software. Results 8 articles involving 9 studies with 1165 patients were included in our meta-analysis. Our results suggested that elevated RDW is significantly associated with poor prognosis in MM (OS: HR = 1.91, 95%CI: 1.48–2.46; PFS: HR = 2.87, 95% CI: 2.02–4.07). A significant correlation was not found between RDW and International Staging System (ISS) staging (ISS III VS ISS I-II: OR:1.53; 95%CI:0.97–2.42). Conclusion Our results suggested that RDW is a robust predictor of newly diagnosed MM outcomes.
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Affiliation(s)
- Xiaomin Chen
- Stem Cell Laboratory, Affiliated Hospital of Southwest Medical University, Luzhou City, Sichuan Province, China
| | - Jiayue Liu
- Stem Cell Laboratory, Affiliated Hospital of Southwest Medical University, Luzhou City, Sichuan Province, China
| | - Jialin Duan
- Stem Cell Laboratory, Affiliated Hospital of Southwest Medical University, Luzhou City, Sichuan Province, China
| | - Hao Xiong
- Stem Cell Laboratory, Affiliated Hospital of Southwest Medical University, Luzhou City, Sichuan Province, China
| | - Yang Liu
- Stem Cell Laboratory, Affiliated Hospital of Southwest Medical University, Luzhou City, Sichuan Province, China
| | - Xinwen Zhang
- Stem Cell Laboratory, Affiliated Hospital of Southwest Medical University, Luzhou City, Sichuan Province, China
| | - Chunlan Huang
- Stem Cell Laboratory, Affiliated Hospital of Southwest Medical University, Luzhou City, Sichuan Province, China.
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2
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Herraez I, Bento L, Del Campo R, Sas A, Ramos R, Ibarra J, Mestre F, Alemany R, Bargay J, Sampol A, Gutierrez A. Prognostic Role of the Red Blood Cell Distribution Width (RDW) in Hodgkin Lymphoma. Cancers (Basel) 2020; 12:cancers12113262. [PMID: 33158258 PMCID: PMC7694294 DOI: 10.3390/cancers12113262] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2020] [Revised: 10/22/2020] [Accepted: 11/01/2020] [Indexed: 02/08/2023] Open
Abstract
The red blood cell distribution width (RDW) is a parameter available from an automated blood count, which measures the degree of heterogeneity of erythrocyte volume and increases in inflammatory conditions. The prognostic role of RDW has been described in different types of cancers. Hodgkin lymphoma (HL) is a hematological malignancy, known to have a proinflammatory background. We aim to study the prognostic role of RDW in HL. We retrospectively analyzed 264 patients with HL from two hospitals in the Balearic Islands between 1990 and 2018. Higher levels of RDW were independently related to anemia, B-symptoms, and low albumin. In age ≥45 years, the presence of lymphopenia and higher RDW were independently associated with worse event-free survival (EFS) and overall survival (OS). Long-term incidence of secondary malignancies was significantly higher in patients with higher RDW, particularly lung cancer. In conclusion, we report for the first time that RDW is a simple, cheap, and easily available prognostic factor in HL that identifies a group with worse EFS, OS, and a higher potential incidence of secondary malignancies. RDW seems to be related to most adverse prognostic factors in HL, making RDW an excellent candidate to be included in prognostic scores for HL.
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Affiliation(s)
- Ines Herraez
- Department of Hematology, Son Llatzer University Hospital, 07198 Palma de Mallorca, Spain; (I.H.); (R.D.C.); (J.B.)
- Health Research Institute of the Balearic Islands (IdISBa-IUNICS), 07120 Palma de Mallorca, Spain
- Department of Hematology, Son Espases University Hospital, 07120 Palma de Mallorca, Spain; (L.B.); (A.S.); (A.S.)
| | - Leyre Bento
- Health Research Institute of the Balearic Islands (IdISBa-IUNICS), 07120 Palma de Mallorca, Spain
- Department of Hematology, Son Espases University Hospital, 07120 Palma de Mallorca, Spain; (L.B.); (A.S.); (A.S.)
| | - Raquel Del Campo
- Department of Hematology, Son Llatzer University Hospital, 07198 Palma de Mallorca, Spain; (I.H.); (R.D.C.); (J.B.)
- Health Research Institute of the Balearic Islands (IdISBa-IUNICS), 07120 Palma de Mallorca, Spain
| | - Adriana Sas
- Health Research Institute of the Balearic Islands (IdISBa-IUNICS), 07120 Palma de Mallorca, Spain
- Department of Hematology, Son Espases University Hospital, 07120 Palma de Mallorca, Spain; (L.B.); (A.S.); (A.S.)
| | - Rafael Ramos
- Health Research Institute of the Balearic Islands (IdISBa-IUNICS), 07120 Palma de Mallorca, Spain
- Department of Pathology, Son Espases University Hospital, 07120 Palma de Mallorca, Spain;
| | - Javier Ibarra
- Health Research Institute of the Balearic Islands (IdISBa-IUNICS), 07120 Palma de Mallorca, Spain
- Department of Pathology, Son Llatzer University Hospital, 07198 Palma de Mallorca, Spain;
| | - Francesc Mestre
- Health Research Institute of the Balearic Islands (IdISBa-IUNICS), 07120 Palma de Mallorca, Spain
- Department of Radiotherapy, Son Espases University Hospital, 07120 Palma de Mallorca, Spain;
| | - Regina Alemany
- Health Research Institute of the Balearic Islands (IdISBa-IUNICS), 07120 Palma de Mallorca, Spain
- Department of Biology, University of Balearic Islands, 07122 Palma de Mallorca, Spain;
| | - Joan Bargay
- Department of Hematology, Son Llatzer University Hospital, 07198 Palma de Mallorca, Spain; (I.H.); (R.D.C.); (J.B.)
- Health Research Institute of the Balearic Islands (IdISBa-IUNICS), 07120 Palma de Mallorca, Spain
| | - Antonia Sampol
- Health Research Institute of the Balearic Islands (IdISBa-IUNICS), 07120 Palma de Mallorca, Spain
- Department of Hematology, Son Espases University Hospital, 07120 Palma de Mallorca, Spain; (L.B.); (A.S.); (A.S.)
| | - Antonio Gutierrez
- Health Research Institute of the Balearic Islands (IdISBa-IUNICS), 07120 Palma de Mallorca, Spain
- Department of Hematology, Son Espases University Hospital, 07120 Palma de Mallorca, Spain; (L.B.); (A.S.); (A.S.)
- Correspondence: ; Tel.: +34-(8)-7120-5000 (ext. 65115)
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Beltran BE, Paredes S, Castro D, Cotrina E, Sotomayor EM, Castillo JJ. High Red Cell Distribution Width is an Adverse Predictive and Prognostic Factor in Patients With Diffuse Large B-Cell Lymphoma Treated With Chemoimmunotherapy. CLINICAL LYMPHOMA MYELOMA & LEUKEMIA 2019; 19:e551-e557. [PMID: 31320254 DOI: 10.1016/j.clml.2019.06.005] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/05/2019] [Accepted: 06/08/2019] [Indexed: 12/11/2022]
Abstract
INTRODUCTION The red blood cell distribution width (RDW) is an easy-to-obtain laboratory value that has emerged as a potential prognostic factor in solid and hematologic malignancies. PATIENTS AND METHODS We evaluated 121 patients with de novo diffuse large B-cell lymphoma (DLBCL) treated with standard chemoimmunotherapy at our institution between 2010 and 2012. We categorized patients with high RDW (> 14.6%) and normal RDW (11.6%-14.6%). We fitted multivariate regression models for complete response (CR) and overall survival (OS). RESULTS Patients with high RDW were less likely to achieve CR to chemoimmunotherapy than patients with normal RDW (48% vs. 83%; P < .001). The 5-year OS rate for patients with high RDW was lower than in patients with normal RDW (51% vs. 79%; P = .001). In multivariate regression models, high RDW was independently associated with lower odds of achieving CR (odds ratio, 0.32; 95% confidence interval [CI], 0.12-0.83; P = .02) and with higher risk of death from any cause (hazard ratio [HR], 2.04; 95% CI, 1.03-4.02; P = .04) than normal RDW in patients with DLBCL treated with chemoimmunotherapy. High RDW remained an independent adverse factor for OS after adjustment for the International Prognostic Index and the National Comprehensive Cancer Network-International Prognostic Index scores with HR 2.20 (95% CI, 1.12-4.31; P = .02) and HR 2.67 (95% CI 1.28-5.59; P = .009), respectively. CONCLUSION High RDW appears to be an adverse predictive and prognostic factor in patients with de novo DLBCL treated with R-CHOP (rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisone).
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Affiliation(s)
- Brady E Beltran
- Department of Oncology and Radiotherapy, Hospital Nacional Edgardo Rebagliati Martins, Lima, Peru; Centro de Medicina de Precisión, Universidad de San Martin de Porres, Lima, Peru.
| | - Sally Paredes
- Department of Oncology and Radiotherapy, Hospital Nacional Edgardo Rebagliati Martins, Lima, Peru
| | - Denisse Castro
- Department of Oncology and Radiotherapy, Hospital Nacional Edgardo Rebagliati Martins, Lima, Peru
| | - Esther Cotrina
- Department of Nursing, Hospital Nacional Edgardo Rebagliati Martins, Lima, Peru
| | - Eduardo M Sotomayor
- George Washington Cancer Center, George Washington University, Washington, DC
| | - Jorge J Castillo
- Division of Hematologic Malignancies, Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA
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Wang PF, Song SY, Guo H, Wang TJ, Liu N, Yan CX. Prognostic role of pretreatment red blood cell distribution width in patients with cancer: A meta-analysis of 49 studies. J Cancer 2019; 10:4305-4317. [PMID: 31413750 PMCID: PMC6691718 DOI: 10.7150/jca.31598] [Citation(s) in RCA: 44] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2018] [Accepted: 05/08/2019] [Indexed: 12/11/2022] Open
Abstract
Red blood cell distribution width (RDW) has been recently demonstrated to be a predictor of inflammation. High pretreatment RDW level is associated with poor survival outcomes in various malignancies, although the results are controversial. We aimed to investigate the prognostic role of RDW. A systematic literature search was performed in MEDLINE and EMBASE till April 2018. Pooled hazard ratios (HRs) were estimated for overall survival (OS) and combined disease-free survival, progression-free survival, and recurrence-free survival (DFS/PFS/RFS). 49 studies with 19,790 individuals were included in the final analysis. High RDW level adversely affected both OS and DFS/PFS/RFS. For solid cancers, colorectal cancer (CRC) had the strongest relationship with poor OS, followed by hepatic cancer (HCC). Negative OS outcomes were also observed in hematological malignancies. Furthermore, patients at either early or advanced stage had inverse relationship between high pretreatment RDW and poor OS. Studies with cut-off values between 13% and 14% had worse HRs for OS and DFS/PFS/RFS than others. Furthermore, region under the curve (ROC) analysis was used widely to define cut-off values and had relatively closer relationship with poorer HRs. In conclusion, our results suggested that elevated pretreatment RDW level could be a negative predictor for cancer prognosis.
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Affiliation(s)
- Peng-Fei Wang
- Department of Neurosurgery, Sanbo Brain Hospital, Capital Medical University, Beijing, China
| | - Si-Ying Song
- School of Basic Medical Sciences, Capital Medical University, Beijing, China
| | - Hang Guo
- Department of Neurosurgery, Sanbo Brain Hospital, Capital Medical University, Beijing, China
- Department of Orthopedics, Shanghai Pudong New Area Gongli Hospital, Naval Military Medical University, Shanghai, China
| | - Ting-Jian Wang
- Department of Neurosurgery, Sanbo Brain Hospital, Capital Medical University, Beijing, China
| | - Ning Liu
- Department of Neurosurgery, Sanbo Brain Hospital, Capital Medical University, Beijing, China
| | - Chang-Xiang Yan
- Department of Neurosurgery, Sanbo Brain Hospital, Capital Medical University, Beijing, China
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Miao Y, Zhou XH, Guo JJ, Sun Q, Shi K, Wu JZ, Zhu HY, Wang L, Fan L, Xu W, Li JY. Association of red blood cell distribution width and outcomes in patients with mantle cell lymphoma. Cancer Med 2019; 8:2751-2758. [PMID: 30980510 PMCID: PMC6558583 DOI: 10.1002/cam4.2155] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2018] [Revised: 02/19/2019] [Accepted: 03/26/2019] [Indexed: 12/11/2022] Open
Abstract
Red blood cell distribution width (RDW), which measures the range of variation of red blood cell volume, has been explored as a prognostic factor in multiple types of cancer. However, the role of RDW in mantle cell lymphoma (MCL), a rare type of non-Hodgkin lymphoma with poor outcomes, remains to be determined. Therefore, we investigated the prognostic role of RDW in MCL. We found that 21 of 76 MCL patients (27.6%) had an abnormally elevated RDW (>15.7%). Abnormally elevated RDW was significantly associated with presence of B symptoms (P = 0.0020), elevated lactate dehydrogenase (LDH) (P = 0.0010), higher leukocyte count (P = 0.0345), higher simplified Mantle Cell International Prognostic Index (sMIPI) (P = 0.0194), and lower level of hemoglobin (Hb) (P < 0.0001). It was marginally associated with increased C-reactive protein (P = 0.0862). RDW was significantly correlated with Hb level (r2 = 0.42) and LDH level (r2 = 0.19). 15.8% was determined as the best cutoff of RDW in predicting the survival outcome by the X-tile software. Survival analysis revealed that high RDW (>15.8%) predicted shorter progression-free survival (PFS) (hazards ratio [HR]: 3.14; P = 0.0005) and shorter overall survival (OS) (HR: 4.04; P < 0.0001). High RDW independently predicted both shorter PFS (P = 0.0493) and OS (P = 0.0118). RDW also improved the prognostic stratification based on sMIPI. In conclusion, our study identified RDW as a novel prognostic factor of clinical feasibility in the prognostication of MCL.
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Affiliation(s)
- Yi Miao
- Department of Hematology, The First Affiliated Hospital of Nanjing Medical University, Jiangsu Province Hospital, Nanjing, China.,Key Laboratory of Hematology of Nanjing Medical University, Nanjing, China.,Collaborative Innovation Center for Cancer Personalized Medicine, Nanjing, China
| | - Xiao-Hui Zhou
- Department of Hematology, The First Affiliated Hospital of Nanjing Medical University, Jiangsu Province Hospital, Nanjing, China.,Key Laboratory of Hematology of Nanjing Medical University, Nanjing, China.,Collaborative Innovation Center for Cancer Personalized Medicine, Nanjing, China
| | - Jing-Jing Guo
- Department of Hematology, The First Affiliated Hospital of Nanjing Medical University, Jiangsu Province Hospital, Nanjing, China.,Key Laboratory of Hematology of Nanjing Medical University, Nanjing, China.,Collaborative Innovation Center for Cancer Personalized Medicine, Nanjing, China
| | - Qian Sun
- Department of Hematology, The First Affiliated Hospital of Nanjing Medical University, Jiangsu Province Hospital, Nanjing, China.,Key Laboratory of Hematology of Nanjing Medical University, Nanjing, China.,Collaborative Innovation Center for Cancer Personalized Medicine, Nanjing, China
| | - Ke Shi
- Department of Hematology, The First Affiliated Hospital of Nanjing Medical University, Jiangsu Province Hospital, Nanjing, China.,Key Laboratory of Hematology of Nanjing Medical University, Nanjing, China.,Collaborative Innovation Center for Cancer Personalized Medicine, Nanjing, China
| | - Jia-Zhu Wu
- Department of Hematology, The First Affiliated Hospital of Nanjing Medical University, Jiangsu Province Hospital, Nanjing, China.,Key Laboratory of Hematology of Nanjing Medical University, Nanjing, China.,Collaborative Innovation Center for Cancer Personalized Medicine, Nanjing, China
| | - Hua-Yuan Zhu
- Department of Hematology, The First Affiliated Hospital of Nanjing Medical University, Jiangsu Province Hospital, Nanjing, China.,Key Laboratory of Hematology of Nanjing Medical University, Nanjing, China.,Collaborative Innovation Center for Cancer Personalized Medicine, Nanjing, China
| | - Li Wang
- Department of Hematology, The First Affiliated Hospital of Nanjing Medical University, Jiangsu Province Hospital, Nanjing, China.,Key Laboratory of Hematology of Nanjing Medical University, Nanjing, China.,Collaborative Innovation Center for Cancer Personalized Medicine, Nanjing, China
| | - Lei Fan
- Department of Hematology, The First Affiliated Hospital of Nanjing Medical University, Jiangsu Province Hospital, Nanjing, China.,Key Laboratory of Hematology of Nanjing Medical University, Nanjing, China.,Collaborative Innovation Center for Cancer Personalized Medicine, Nanjing, China
| | - Wei Xu
- Department of Hematology, The First Affiliated Hospital of Nanjing Medical University, Jiangsu Province Hospital, Nanjing, China.,Key Laboratory of Hematology of Nanjing Medical University, Nanjing, China.,Collaborative Innovation Center for Cancer Personalized Medicine, Nanjing, China
| | - Jian-Yong Li
- Department of Hematology, The First Affiliated Hospital of Nanjing Medical University, Jiangsu Province Hospital, Nanjing, China.,Key Laboratory of Hematology of Nanjing Medical University, Nanjing, China.,Collaborative Innovation Center for Cancer Personalized Medicine, Nanjing, China
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