Abstract
<h3>Context:</h3> Recent studies indicate that higher Red Distribution Width (RDW) at diagnosis in lymphoproliferative malignancies is associated with poor outcome related to a higher proinflammatory status and comorbidities. <h3>Objectives:</h3> To assess the prognostic value of RDW at diagnosis in diffuse large B-cell lymphoma (DLBCL). <h3>Design:</h3> A retrospective cohort study of patients diagnosed with DLBCL between January 2011 and January 2018 in South Egypt Cancer Institute were included in the analysis. <h3>Setting:</h3> The South Egypt Cancer Institute is a tertiary care referral centre located in Upper Egypt. <h3>Patients:</h3> Eighty-three patients with aggressive DLBCL were recruited to the study. The median age at diagnosis was 49 years. Thirty-nine patients were males with a percentage of 47% and 44 patient were females with a percentage of 53%. <h3>Interventions:</h3> Data of CBC including RDW, BM microscopic evaluation, and biochemical markers as albumin, LDH at diagnosis were determined. Records for clinical data as B symptoms and performance status, treatment outcome, and survival rates were evaluated. Cutoff of RDW > 15 was considered as high-risk. <h3>Results:</h3> High RDW > 15 was found in 37 patients (44.6%). For treatment outcome, patients with high RDW >15 demonstrated no difference from the patients with normal RDW as regard achieving complete remission (37% vs 51.4%; p=0.2). Regarding disease characteristics, no variations were found between the group with high RDW and the group with normal RDW in respect of the Ann Arbor stage, B symptoms, and BM infiltration at diagnosis. The median follow-up was 16 months (range 2-76 months) and 19 patients experienced death with a percentage of 22.9%. Cox-regression analysis showed that prognostic factors for overall survival (OS) were: male sex (HR=0.27, p=0.05), performance status (HR=0.2, p=0.01), and LDH (HR=1, p=0.04) and no role for age, stage at diagnosis, presence of bone marrow infiltration at diagnosis, or RDW. <h3>Conclusion:</h3> High RDW failed to show prognostic value in our cohort of DLBCL regard the overall survival or achieving CR post first-line therapy.
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