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.
Highlights
Diffuse large B-cell lymphoma (DLBCL) is the most common form of lymphoma, accounting for 25–30% of all newly diagnosed cases of adult non-Hodgkin lymphoma (NHL)
This study examined the prognostic value of the baseline red blood cell distribution width (RDW) in diffuse large B cell lymphoma (DLBCL) patients
Our results for DLBCL confirm reports by other investigators [12]; we provide evidence that a high RDW at diagnosis is strongly associated with high-risk clinical features in patients who receive rituximab-based chemotherapy
Summary
Diffuse large B-cell lymphoma (DLBCL) is the most common form of lymphoma, accounting for 25–30% of all newly diagnosed cases of adult non-Hodgkin lymphoma (NHL). DLBCL is classified as a heterogeneous entity, encompassing several morphological variants, various biological abnormalities, and variable clinical behaviors and responses to treatment [1]. The International Prognostic Index (IPI), and its variants designed for younger or elderly (e.g., age-adjusted IPI) patients and patients treated with rituximab (e.g., revised R-IPI), are the only widely accepted, validated clinical prognostic indices for DLBCL [2, 3]; some patients with a favorable IPI fail treatment and vice versa. Some prognostically significant molecular and immunohistochemical characteristics of DLBCL have been identified, but cost and technical constraints make their routine application impractical; finding inexpensive, readily available surrogate prognostic markers could make an important contribution to improved risk assessment for individual patients. The presence of systemic inflammation was identified as an independent predictor of the response to treatment, overall survival (OS) and event-free survival in DLBCL patients [6]
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