The Association between Red Cell Distribution Width and Mortality in Pediatric Acute Lymphoblastic Leukemia

Khadijeh Arjmandi Rafsanjani,Azadeh Kiumarsi,Mahsa Fallahi,Vahid Falahati,Shabnam Moghaddam

doi:10.21767/2576-3903.100011

Abstract

Background: Red cell distribution width (RDW) is one of the standard parameters with blood cell counts. Studies have revealed that RDW could be used as a predictor of mortality in different contexts. However, data about the relation of RDW with hematologic malignancies is limited. In this research, we evaluated the relation of RDW with mortality in pediatric acute lymphoblastic leukemia (ALL). Materials and methods: In the oncology department of a tertiary care children hospital, between years of 2010 to 2013, we had 83 registered cases of acute lymphoblastic leukemia (ALL) whose data was collected and analyzed retrospectively. RDW, mean corpuscular volume (MCV), hemoglobin (Hgb) and platelet (Plt) measurements were recorded and their relation with mortality, leukemia relapses and treatment cessation was examined. Results: A total 83 patients were enrolled in the study. The mean age was 5.5 years and 50 (60.2%) were male. The mean baseline RDW level was 16.0%, and it ranged from 11.2% to 23.2%. During the study period, 12(14.5%) cases had died. The rate of mortality did not significantly correlate with RDW level. Conclusions: Although a relationship between elevated RDW and mortality has been reported in several contexts, we did not find any significant correlation between the RDW level and the rate of mortality and relapse in pediatric patients with acute lymphoblastic leukemia (ALL).

Highlights

Red cell distribution width (RDW) is a laboratory parameter which expresses the variability in red blood cell size and is calculated as the standard deviation in red blood cell (RBC) size divided by the mean corpuscular volume (MCV)
Conclusions: a relationship between elevated RDW and mortality has been reported in several contexts, we did not find any significant correlation between the RDW level and the rate of mortality and relapse in pediatric patients with acute lymphoblastic leukemia (ALL)
In a study by Iriyama et al CML associated deaths were more common in the high-RDW group [22]. Most of these studies have investigated the relationship between RDW and cancer among elderly populations in whom RDW could reflect comorbidities such as age, risk of cardiovascular complications, and severity of renal impairment [28]

Summary

Introduction

Red cell distribution width (RDW) is a laboratory parameter which expresses the variability in red blood cell size and is calculated as the standard deviation in red blood cell (RBC) size divided by the mean corpuscular volume (MCV). It is a widely available and low-cost test. The aim of this study is to evaluate the correlation between RDW and mortality in pediatric acute lymphoblastic leukemia patients. We evaluated the relation of RDW with mortality in pediatric acute lymphoblastic leukemia (ALL). The rate of mortality did not significantly correlate with RDW level

Objectives

Methods

Discussion

Conclusion