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Stefaniuk P, Muzyka-Kasietczuk J, Koczkodaj D, Hus M, Podhorecka M. Reading Between the Lines: Complete Blood Count-Derived Parameters as Prognostic Factors in Patients With Newly Diagnosed Acute Myeloid Leukemia. Clin Med Insights Oncol 2025; 19:11795549251321360. [PMID: 40144779 PMCID: PMC11938486 DOI: 10.1177/11795549251321360] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2024] [Accepted: 01/23/2025] [Indexed: 03/28/2025] Open
Abstract
Background Research proved the prognostic significance of the neutrophil-to-lymphocyte ratio (NLR), lymphocyte-to-monocyte ratio (LMR), platelet-to-lymphocyte ratio (PLR), and red blood cell distribution width (RDW) in some hematological malignancies. This study aimed to analyze the role of pretreatment NLR, LMR, PLR, RDW coefficient of variation (RDW-CV), and RDW standard deviation (RDW-SD) as prognostic markers for acute myeloid leukemia (AML). Methods This retrospective cohort study included 204 patients newly diagnosed with AML in the Department of Hematooncology and Bone Marrow Transplantation of the Medical University of Lublin. Results In the univariate models, higher RDW-CV and lower LMR predicted a poorer response to induction chemotherapy (odds ratio [OR] = 1.21, 95% confidence interval [CI95] = [1.09-2.36], P < .001; OR = 0.95, CI95 = [0.89-0.99], P = .045, respectively). In the multivariate model, age of diagnosis, ECOG (Performance Status Assessment by Eastern Cooperative Oncology Group) score, cytogenetic risk, NLR, and RDW-CV affected the odds of no response to chemotherapy significantly. The risk of progression was influenced by NLR and RDW-CV in the univariate analysis (hazard ratio [HR] = 1.20, CI95 = [1.09-1.33], P < .001; HR = 1.10, CI95 = [1.04-1.17], P = .002, respectively). In the multivariate settings, cytogenetic risk, leukocyte count, and RDW-CV affected progression free survival (PFS) significantly. Based on univariate models, the risk of death, when overall survival (OS) was taken into account, was influenced by NLR, LMR, and RDW-CV (HR = 1.05, CI95 = [1.00-1.09], P = .034; HR = 0.94, CI95 = [0.89-0.98], P = .010; HR = 1.06, CI95 = [1.01-1.10], P = .014, respectively). Conclusions Higher NLR, higher RDW, lower LMR, and possibly lower PLR are poor prognostic factors that may help in the risk stratification of patients with AML.
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Affiliation(s)
- Paulina Stefaniuk
- Department of Family Medicine, Medical University of Lublin, Lublin, Poland
- Department of Hematooncology and Bone Marrow Transplantation, Medical University of Lublin, Lublin, Poland
| | - Justyna Muzyka-Kasietczuk
- Department of Hematooncology and Bone Marrow Transplantation, Medical University of Lublin, Lublin, Poland
| | - Dorota Koczkodaj
- Department of Cancer Genetics with Cytogenetics Laboratory, Medical University of Lublin, Lublin, Poland
| | - Marek Hus
- Department of Hematooncology and Bone Marrow Transplantation, Medical University of Lublin, Lublin, Poland
| | - Monika Podhorecka
- Department of Hematooncology and Bone Marrow Transplantation, Medical University of Lublin, Lublin, Poland
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Yigit Ayhan E, Pinar IE, Ozkocaman V, Ozkalemkas F. Red Cell Distribution Width at Diagnosis Reflects Advanced Disease While Dynamic Changes Predict Survival at Relapse in Multiple Myeloma: A Retrospective Study. Cureus 2024; 16:e75662. [PMID: 39803057 PMCID: PMC11725307 DOI: 10.7759/cureus.75662] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/13/2024] [Indexed: 01/16/2025] Open
Abstract
Introduction Multiple myeloma (MM) is a complex plasma cell malignancy characterized by clonal proliferation and monoclonal immunoglobulin production. Despite the availability of several prognostic markers for MM, many are challenging to implement routine clinical practice due to cost, complexity, or lack of standardization. Red cell distribution width (RDW), a cost-effective and routinely measured parameter in complete blood counts, has gained increasing attention as a prognostic marker due to its association with disease severity and outcomes in MM. This study investigates the prognostic utility of RDW in MM, focusing on its relationship with patient outcomes, particularly in those undergoing autologous stem cell transplantation (ASCT). Methods This retrospective study included 218 patients diagnosed with MM between 2010 and 2018. Demographic, clinical, and laboratory data, including RDW levels at ASCT and first relapse, were collected. Patients were stratified into high (>16.5%) and low (≤16.5%) RDW groups. The impact of RDW levels and their changes on progression-free survival (PFS) and overall survival (OS) were analyzed using Kaplan-Meier and log-rank tests. Results Higher RDW levels at diagnosis were significantly associated with advanced disease stages, notably R-ISS stage 3 (p=0.022). While no significant survival differences were observed based on baseline RDW levels, dynamic changes in RDW from diagnosis to first relapse were strongly prognostic. Patients maintaining low RDW had the longest PFS (37 months) and OS (88.8 months), whereas those transitioning from low to high RDW experienced the shortest PFS (nine months) and OS (40.6 months). At relapse, patients with low RDW demonstrated superior outcomes (PFS: 34 vs. 14 months, OS: 81.2 vs. 40.6 months; p<0.001). ASCT markedly improved survival outcomes, with longer PFS (p=0.028) and OS (p<0.001). Higher hemoglobin levels (>10 g/dL) were also associated with extended PFS (p=0.038). Reassessing RDW prior to ASCT did not yield significant differences, suggesting that the prognostic value of RDW lies in its dynamic changes, particularly around relapse events. Conclusions RDW levels at diagnosis reflect advanced disease stages in MM but are not independent predictors of survival. However, dynamic changes in RDW, particularly from diagnosis to relapse, highlight its potential as a robust marker for monitoring disease progression and relapse risk. ASCT remains a cornerstone of MM management, significantly improving survival outcomes and complementing RDW trends in prognosis. Standardizing RDW thresholds and integrating its dynamic trends into clinical workflows could enhance risk stratification and personalized treatment strategies. Prospective, multi-center trials are essential to validate these findings and establish RDW's role in comprehensive prognostic frameworks for MM.
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Affiliation(s)
- Elif Yigit Ayhan
- Department of Internal Medicine, Bursa Uludag University, Bursa, TUR
| | - Ibrahim E Pinar
- Department of Internal Medicine, Isparta City Hospital, Isparta, TUR
| | - Vildan Ozkocaman
- Department of Internal Medicine, Bursa Uludag University, Bursa, TUR
| | - Fahir Ozkalemkas
- Department of Internal Medicine, Bursa Uludag University, Bursa, TUR
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Li M, Wu H, Shou C, Peng Y, Song X, Ying W, Chen Y, Tong X. Optimal cut-off values and diagnostic significance of clinical laboratory indicators in newly diagnosed multiple myeloma. Discov Oncol 2024; 15:477. [PMID: 39331239 PMCID: PMC11436520 DOI: 10.1007/s12672-024-01254-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/21/2024] [Accepted: 08/20/2024] [Indexed: 09/28/2024] Open
Abstract
OBJECTIVE This study aims to identify clinical laboratory parameters for the diagnosis of newly diagnosed multiple myeloma (NDMM), establish optimal cutoffs for early screening, and develop a diagnostic model for precise diagnosis. METHODS The study conducted a retrospective analysis of 279 NDMM patients and 553 healthy subjects at Zhejiang Province People's Hospital between January 2008 and June 2023. Multifactor LR was employed to explore clinical laboratory indicators with diagnostic value for NDMM, determine optimal cutoff values and contract a diagnostic model. The diagnostic efficacy and clinical utility were evaluated using receiver operating characteristic curves (ROC), sensitivity, specificity, and other indicators. RESULTS Multifactor analysis revealed that hemoglobin (Hb), albumin (Alb), and platelet distribution width (PDW) were significant diagnostic factors for NDMM. Optimal cutoff values for Hb, Alb, and PDW in MM diagnosis were determined, and the results showed a significant increase in the probability of NDMM diagnosis when Alb was below 39.3 g/L, Hb was below 11.6 g/dL, and PDW was below 14.1 fL. The diagnostic model constructed from the development cohort demonstrated a high area under the ROC curve of 0.960 (95% CI 0.942-0.978) and exhibited good sensitivity (0.860), specificity (0.957). The area under the curve (AUC) value of the diagnostic model in the external validation cohort was 0.979, confirming its good diagnostic efficacy and generalization. CONCLUSIONS The optimal cutoff values for Hb, Alb, and PDW and the diagnostic model designed in the study provided good accuracy and sensitivity for the initial screening and diagnosis of NDMM.
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Affiliation(s)
- Manning Li
- Graduate School of Clinical Medicine, Jinzhou Medical University, 40 Songpo Road, Jinzhou, 121001, Liaoning, China
- Cancer Center, Department of Hematology, Affiliated People's Hospital, Zhejiang Provincial People's Hospital, Hangzhou Medical College, 158 Shangtang Road, Hangzhou, 310014, Zhejiang, People's Republic of China
| | - Han Wu
- Graduate School of Clinical Medicine, Jinzhou Medical University, 40 Songpo Road, Jinzhou, 121001, Liaoning, China
- Cancer Center, Department of Hematology, Affiliated People's Hospital, Zhejiang Provincial People's Hospital, Hangzhou Medical College, 158 Shangtang Road, Hangzhou, 310014, Zhejiang, People's Republic of China
| | - Chunyi Shou
- Cancer Center, Department of Hematology, Affiliated People's Hospital, Zhejiang Provincial People's Hospital, Hangzhou Medical College, 158 Shangtang Road, Hangzhou, 310014, Zhejiang, People's Republic of China
| | - Ye Peng
- Cancer Center, Department of Hematology, Affiliated People's Hospital, Zhejiang Provincial People's Hospital, Hangzhou Medical College, 158 Shangtang Road, Hangzhou, 310014, Zhejiang, People's Republic of China
| | - Xiaolu Song
- Cancer Center, Department of Hematology, Affiliated People's Hospital, Zhejiang Provincial People's Hospital, Hangzhou Medical College, 158 Shangtang Road, Hangzhou, 310014, Zhejiang, People's Republic of China
| | - Wang Ying
- Department of Central Laboratory, Affiliated Hangzhou First People's Hospital, Xihu University, 261 Huansha Road, Hangzhou, 310006, Zhejiang, People's Republic of China.
| | - Yirui Chen
- Cancer Center, Department of Hematology, Affiliated People's Hospital, Zhejiang Provincial People's Hospital, Hangzhou Medical College, 158 Shangtang Road, Hangzhou, 310014, Zhejiang, People's Republic of China.
| | - Xiangmin Tong
- Cancer Center, Department of Hematology, Affiliated People's Hospital, Zhejiang Provincial People's Hospital, Hangzhou Medical College, 158 Shangtang Road, Hangzhou, 310014, Zhejiang, People's Republic of China.
- Department of Hematology, Affiliated Hangzhou First People's Hospital, Xihu University, 261 Huansha Road, Hangzhou, 310006, Zhejiang, People's Republic of China.
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Lu SY, Ortoleva J, Colon K, Mueller A, Laflam A, Shelton K, Dalia AA. Red blood cell distribution width predicts mortality of adult patients receiving veno-arterial extracorporeal membrane oxygenation. Perfusion 2024; 39:935-942. [PMID: 37341618 DOI: 10.1177/02676591231169850] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/22/2023]
Abstract
BACKGROUND Red blood cell distribution width (RDW) is a numerical measure of the variation in the size of circulating red blood cells. Recently, there is increasing interest in the role of RDW as a biomarker for inflammatory states and as a prognostication tool for a wide range of clinical manifestations. The predictive power of RDW on mortality among patients receiving mechanical circulatory support remains largely unknown. METHODS A retrospective analysis of 281 VA-ECMO patients at a tertiary referral academic hospital from 2009 to 2019 was performed. RDW was dichotomized with RDW-Low <14.5% and RDW-High ≥14.5%. The primary outcome was all-cause mortality at 30 days and 1 year. Cox proportional hazards models were used to examine the association between RDW and the clinical outcomes after adjusting for additional confounders. RESULTS 281 patients were included in the analysis. There were 121 patients (43%) in the RDW-Low group and 160 patients (57%) in the RDW-High group. Survival to ECMO decannulation [RDW-H: 58% versus RDW-L: 67%, p = 0.07] were similar between the two groups. Patients in RDW-H group had higher 30-days mortality (RDW-H: 67.5% vs RDW-L: 39.7%, p < 0.001) and 1 year mortality (RDW-H: 79.4% vs RDW-L: 52.9%, p < 0.001) compared to patients in the RDW-L group. After adjusting for confounders, Cox proportional hazards model demonstrated that patients with high RDW had increased odds of mortality at 30 days (hazard ratio 1.9, 95% CI 1.2-3.0, p < 0.01) and 1 year (hazard ratio 1.9, 95% CI 1.3-2.8, p < 0.01) compared to patients with low RDW. CONCLUSIONS Among patients receiving mechanical circulatory support with VA-ECMO, a higher RDW was independently associated with increased 30-days and 1-year mortality. RDW may serve as a simple biomarker that can be quickly obtained to help provide risk stratification and predict survival for patients receiving VA-ECMO.
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Affiliation(s)
- Shu Y Lu
- Department of Anesthesia, Critical Care and Pain Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Jamel Ortoleva
- Department of Anesthesiology and Perioperative Medicine, Tufts Medical Center, Boston, MA, USA
| | - Katia Colon
- Department of Anesthesia, Critical Care and Pain Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Ariel Mueller
- Department of Anesthesia, Critical Care and Pain Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Andrew Laflam
- Department of Anesthesia, Critical Care and Pain Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Kenneth Shelton
- Department of Anesthesia, Critical Care and Pain Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Adam A Dalia
- Department of Anesthesia, Critical Care and Pain Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
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Carlisi M, Presti RL, Plano F, Mancuso S, Siragusa S, Caimi G. Changes in RDW according to prognostic predictors in newly diagnosed multiple myeloma. Sci Rep 2024; 14:2832. [PMID: 38310176 PMCID: PMC10838310 DOI: 10.1038/s41598-024-53385-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2023] [Accepted: 01/31/2024] [Indexed: 02/05/2024] Open
Abstract
RDW is an erythrocyte index that increase in multiple myeloma, in which it appears to have an important role in predicting outcome. For this reason, we performed a retrospective analysis to evaluate the relationships of RDW with some important prognostic predictors. Specifically, in a cohort of 190 newly diagnosed multiple myeloma patients, we have examined the behaviour of RDW and its trend in relation to the ISS stage and other prognostic factors, such as albumin, beta-2 microglobulin, LDH and bone marrow plasma cell infiltration. We performed the analysis in the entire cohort of patients and in the three different disease isotypes (Light chain, IgA, and IgG multiple myeloma). The evaluation of RDW in the different isotypes was made with the Kruskal-Wallis test, integrated by the Dunn test. The comparison between the subgroups allocated above and below the median value of each prognostic factor, was made with the Mann-Whitney test. From our analysis, we observed that RDW is higher in the IgA multiple myeloma, and it increases significantly from ISS I to III. Moreover, RDW increases in the presence of lower albumin values, higher levels of beta2-microglobulin and LDH and in the presence of a greater bone marrow plasma cell infiltrate.
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Affiliation(s)
- Melania Carlisi
- Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties, University of Palermo, Via del Vespro 129, 90127, Palermo, Italy.
| | - R Lo Presti
- Department of Psychology, Educational Science and Human Movement, University of Palermo, Palermo, Italy
| | - F Plano
- Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties, University of Palermo, Via del Vespro 129, 90127, Palermo, Italy
| | - S Mancuso
- Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties, University of Palermo, Via del Vespro 129, 90127, Palermo, Italy
| | - S Siragusa
- Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties, University of Palermo, Via del Vespro 129, 90127, Palermo, Italy
| | - G Caimi
- Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties, University of Palermo, Via del Vespro 129, 90127, Palermo, Italy
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Bostankolu Değirmenci B, Yegin ZA, Akdemir ÜÖ, Dede A, Gündem GG, Özkurt ZN, Atay LÖ, Yağcı M. Clinical factors associated with autologous stem cell transplantation outcomes in multiple myeloma: upfront transplant with MEL200 remains the standard of care. Ann Hematol 2024; 103:269-283. [PMID: 37880484 DOI: 10.1007/s00277-023-05511-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2023] [Accepted: 10/12/2023] [Indexed: 10/27/2023]
Abstract
Autologous stem cell transplantation (ASCT) remains the mainstay of the treatment in newly diagnosed transplant-eligible multiple myeloma (MM) patients. This retrospective study was performed to investigate the potential prognostic markers which may modify transplant course in a total of 256 ASCT recipients [median age: 58 (30-74) years; male/female: 138/118], including pretransplant (PET0) and day + 60 (PET2) PET/CT assessments and comparative analysis of melphalan (Mel) dose. Better responses with significantly higher complete response/very good partial response rates were achieved in patients who proceeded to transplant within 301 days from diagnosis (p < 0.001). Patients who had received < 1.5 lines of treatment prior to transplant had significantly higher probability of overall survival (OS) (p = 0.004) and progression-free survival (PFS) (p < 0.001). The probability of OS was significantly higher in patients with low Eastern Cooperative Oncology Group (ECOG) performance score (PS = 0-1) (p = 0.003) and HCT-Comorbidity Index (HCT-CI = 0) (p = 0.011). The number of involved areas (p = 0.028) and maximum standardized uptake value (SUVmax) (p = 0.021) in PET0 represented significant impact on OS. The probabilities of OS (p < 0.001) and PFS (p = 0.01) were significantly better with Mel200 mg/m2 conditioning compared to Mel140 mg/m2. Conditioning with Mel200 mg/m2, early and upfront ASCT and low pretransplant treatment burden were found to be significantly associated with ASCT outcome in MM patients. Despite its predictor impact on survival and prognosis, further studies are warranted to standardize PET/CT-based response assessments before being used as a guide for treatment decisions in clinical practice.
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Affiliation(s)
| | - Zeynep Arzu Yegin
- Department of Hematology, Gazi University Faculty of Medicine, Ankara, Turkey.
| | - Ümit Özgür Akdemir
- Department of Nuclear Medicine, Gazi University Faculty of Medicine, Ankara, Turkey
| | - Ali Dede
- Department of Internal Medicine, Gazi University Faculty of Medicine, Ankara, Turkey
| | - Gonca Gül Gündem
- Department of Internal Medicine, Gazi University Faculty of Medicine, Ankara, Turkey
| | - Zübeyde Nur Özkurt
- Department of Hematology, Gazi University Faculty of Medicine, Ankara, Turkey
| | - Lütfiye Özlem Atay
- Department of Nuclear Medicine, Gazi University Faculty of Medicine, Ankara, Turkey
| | - Münci Yağcı
- Department of Hematology, Gazi University Faculty of Medicine, Ankara, Turkey
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Zhang X, Zhang Y, Liu F, Zhu J, Liang X, Shi X, Han L, Xu K, Cheng H. Red blood cell distribution width as a prognostic factor in patients with aplastic anemia treated with cyclosporin A plus androgen or cyclosporine A alone: a retrospective study. Hematology 2023; 28:2240665. [PMID: 37594305 DOI: 10.1080/16078454.2023.2240665] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2023] [Accepted: 07/20/2023] [Indexed: 08/19/2023] Open
Abstract
OBJECTIVE To explore the prognostic value of red blood cell distribution width (RDW) in newly diagnosed aplastic anemia (AA) patients treated with cyclosporine A (CsA) plus androgen or CsA alone. METHODS We retrospectively analyzed the clinical outcome of 220 patients with AA. According to the baseline level of RDW before treatment, the patients were divided into the high-RDW group (RDW ≥ 15%) and the normal-RDW group (RDW < 15%). RESULTS The median RDW of non-severe AA (NSAA) and severe AA (SAA) patients was 15.65% and 15.35%, respectively; this were significantly higher than that of very severe AA (VSAA) patients (13.35%). With median follow-up being 46 months, AA patients in the high-RDW group showed better 5-year OS and PFS than the normal-RDW group (93%: 75.3%; 74.3%: 61%). There was a higher ORR in the high-RDW group than the normal-RDW group (68.7%: 52.3%). The ORR of NSAA patients in the high-RDW group was better than that in the normal RDW group (75.8%: 60%). The 5-year OS of SAA/VSAA patients in the high-RDW group was significantly higher than the normal-RDW group (81.8%: 50.8%). CONCLUSION This is the first documentation on the prognostic value of RDW in AA patients receiving CsA treatment with long-term follow-up, which had shown that high RDW at diagnosis was a better prognostic factor.
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Affiliation(s)
- Xiaotian Zhang
- Department of Hematology, Affiliated Hospital of Xuzhou Medical University, Jiangsu, China
| | - Yanan Zhang
- Department of Hematology, Affiliated Hospital of Xuzhou Medical University, Jiangsu, China
| | - Fengan Liu
- Department of Hematology, Affiliated Hospital of Xuzhou Medical University, Jiangsu, China
| | - Jingjing Zhu
- Department of Hematology, Affiliated Hospital of Xuzhou Medical University, Jiangsu, China
| | - Xiuli Liang
- Department of Hematology, Affiliated Hospital of Xuzhou Medical University, Jiangsu, China
| | - Xuedong Shi
- Department of Hematology, Affiliated Hospital of Xuzhou Medical University, Jiangsu, China
| | - Li Han
- Department of Hematology, Affiliated Hospital of Xuzhou Medical University, Jiangsu, China
| | - Kailin Xu
- Department of Hematology, Affiliated Hospital of Xuzhou Medical University, Jiangsu, China
- Institute of Hematology, Xuzhou Medical University, Jiangsu, China
- Key Laboratory of Bone Marrow Stem Cell, Xuzhou, People's Republic of China
| | - Hai Cheng
- Department of Hematology, Affiliated Hospital of Xuzhou Medical University, Jiangsu, China
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Yan S, Kong J, Zhao ZF, Yao H. The prognostic importance of red blood cell distribution width for gastric cancer: a systematic review and meta-analysis. Transl Cancer Res 2023; 12:1816-1825. [PMID: 37588748 PMCID: PMC10425649 DOI: 10.21037/tcr-23-53] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2023] [Accepted: 05/11/2023] [Indexed: 08/18/2023]
Abstract
Background For cancer patients, red blood cell distribution width (RDW) is a readily accessible and cost-effective preoperative prognostic predictor. This study aimed to determine whether RDW is a predictive factor for individuals undergoing radical surgery for gastric cancer (GC). Methods A literature search was performed to select relevant studies for inclusion in the subsequent meta-analysis. Relevant data were pooled to assess the association between RDW and GC results, including overall survival (OS), disease-free survival (DFS), and cancer-specific survival (CSS), as well as clinicopathological features. Results The meta-analysis and systemic review included data from 8 studies comprising 1,587 individuals diagnosed with GC. In this context, RDW refers to the coefficient of variation of RDW (RDW-CV). A high level of RDW-CV was significantly associated with older age [odds ratio (OR) =2.25; 95% confidence interval (CI): 1.72-2.94; P<0.00001], larger tumor diameter (OR =1.90; 95% CI: 1.42-2.56; P<0.0001), and vascular invasion (OR =2.22; 95% CI: 1.10-4.49; P=0.03). After hazard ratios (HRs) and 95% CIs were pooled, RDW-CV was found to be an independent prognostic factor of OS (HR =1.79; 95% CI: 1.21-2.66; I2=85%; P=0.004), DFS (HR =1.81; 95% CI: 1.37-2.39; I2=0%; P<0.0001), and CSS (HR =2.73; 95% CI: 1.36-5.49; I2=0%; P=0.005) in patients with GC. Conclusions The association between high levels of RDW-CV and poor survival in GC suggests that RDW-CV may be a viable prognostic indicator for patients with GC.
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Affiliation(s)
- Shuai Yan
- Department of Gastrointestinal Surgery, The Affiliated Hospital of Southwest Medical University, Luzhou, China
- School of Clinical Medical Sciences, Southwest Medical University, Luzhou, China
| | - Jian Kong
- Department of Gastrointestinal Surgery, The Affiliated Hospital of Southwest Medical University, Luzhou, China
- School of Clinical Medical Sciences, Southwest Medical University, Luzhou, China
| | - Zheng-Fei Zhao
- Department of Gastrointestinal Surgery, The Affiliated Hospital of Southwest Medical University, Luzhou, China
- School of Clinical Medical Sciences, Southwest Medical University, Luzhou, China
| | - Hui Yao
- Department of Gastrointestinal Surgery, The Affiliated Hospital of Southwest Medical University, Luzhou, China
- School of Clinical Medical Sciences, Southwest Medical University, Luzhou, China
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Zhang Z, Chen Y, Zhuo Q, Deng C, Yang Y, Luo W, Lai S, Rao H. ALDH2 gene rs671 G > a polymorphism and the risk of colorectal cancer: A hospital-based study. J Clin Lab Anal 2022; 36:e24789. [PMID: 36426922 PMCID: PMC9757017 DOI: 10.1002/jcla.24789] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2022] [Revised: 11/11/2022] [Accepted: 11/13/2022] [Indexed: 10/25/2023] Open
Abstract
BACKGROUND The susceptibility to some cancers is linked to genetic factors, such as aldehyde dehydrogenase 2 (ALDH2) polymorphisms. The relationship between ALDH2 rs671 and colorectal cancer (CRC) is not clear in Hakka population. METHODS Between October 2015 and December 2020, a total of 178 CRC patients and 261 controls were recruited. ALDH2 rs671 was genotyped in these subjects, medical records (smoking history, drinking history and blood cell parameters) were collected, and the relationship between these information and CRC was analyzed. RESULTS The proportion of the ALDH2 rs671 G/G, G/A, and A/A genotype was 48.3%, 44.4%, and 7.3% in patients; 62.1%, 34.1%, and 3.8% in controls, respectively. The difference of ALDH2 genotypes distribution between cases and controls was statistically significant (p = 0.011). The higher percentage of smokers and alcoholics, higher level of neutrophil to lymphocyte ratio (NLR), platelet count, and platelet to lymphocyte ratio (PLR), and lower level of lymphocyte count, lymphocyte to monocyte ratio (LMR), and mean hemoglobin concentration were observed in patients. Logistic regression analysis indicated that ALDH2 rs671 G/A genotype (G/A vs. G/G) (adjusted OR 1.801, 95% CI 1.160-2.794, p = 0.009) and A/A genotype (A/A vs. G/G) (adjusted OR 2.630, 95% CI 1.041-6.645, p = 0.041) in the co-dominant model, while G/A + A/A genotypes (G/A + A/A vs. G/G) (adjusted OR 1.883, 95% CI 1.230-2.881, p = 0.004) in the dominant model were risk factors for CRC. CONCLUSIONS Individuals carrying ALDH2 rs671 A allele (G/A, A/A genotypes) may be at increased risk of colorectal cancer.
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Affiliation(s)
- Zhuoxin Zhang
- Department of Gastrointestinal Surgery, Meizhou People's HospitalMeizhou Academy of Medical SciencesMeizhouChina
- Guangdong Provincial Key Laboratory of Precision Medicine and Clinical Translational Research of Hakka PopulationMeizhou People's Hospital, Meizhou Academy of Medical SciencesMeizhouChina
| | - Yijin Chen
- Guangdong Provincial Key Laboratory of Precision Medicine and Clinical Translational Research of Hakka PopulationMeizhou People's Hospital, Meizhou Academy of Medical SciencesMeizhouChina
- Department of GastroenterologyMeizhou People's Hospital, Meizhou Academy of Medical SciencesMeizhouChina
| | - Qingqing Zhuo
- Guangdong Provincial Key Laboratory of Precision Medicine and Clinical Translational Research of Hakka PopulationMeizhou People's Hospital, Meizhou Academy of Medical SciencesMeizhouChina
- Department of GastroenterologyMeizhou People's Hospital, Meizhou Academy of Medical SciencesMeizhouChina
| | - Changqing Deng
- Guangdong Provincial Key Laboratory of Precision Medicine and Clinical Translational Research of Hakka PopulationMeizhou People's Hospital, Meizhou Academy of Medical SciencesMeizhouChina
- Department of GastroenterologyMeizhou People's Hospital, Meizhou Academy of Medical SciencesMeizhouChina
| | - Yang Yang
- Guangdong Provincial Key Laboratory of Precision Medicine and Clinical Translational Research of Hakka PopulationMeizhou People's Hospital, Meizhou Academy of Medical SciencesMeizhouChina
- Department of GastroenterologyMeizhou People's Hospital, Meizhou Academy of Medical SciencesMeizhouChina
| | - Wen Luo
- Guangdong Provincial Key Laboratory of Precision Medicine and Clinical Translational Research of Hakka PopulationMeizhou People's Hospital, Meizhou Academy of Medical SciencesMeizhouChina
- Department of GastroenterologyMeizhou People's Hospital, Meizhou Academy of Medical SciencesMeizhouChina
| | - Shixun Lai
- Guangdong Provincial Key Laboratory of Precision Medicine and Clinical Translational Research of Hakka PopulationMeizhou People's Hospital, Meizhou Academy of Medical SciencesMeizhouChina
- Department of GastroenterologyMeizhou People's Hospital, Meizhou Academy of Medical SciencesMeizhouChina
| | - Hui Rao
- Department of GastroenterologyMeizhou People's Hospital, Meizhou Academy of Medical SciencesMeizhouChina
- Department of Laboratory MedicineMeizhou People's Hospital, Meizhou Academy of Medical SciencesMeizhouChina
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10
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ÖZDEMİR DB, KARAYİĞİT A, DİZEN H, ÜNAL B. The role of red cell distribution width in predicting the prognosis of patients with breast cancer. JOURNAL OF HEALTH SCIENCES AND MEDICINE 2022. [DOI: 10.32322/jhsm.1092191] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
Objective: In this study, we aimed to assess the relationship between preoperative red cell distribution width (RDW) and the clinicopathological stage and prognosis of disease in patients operated for invasive epithelial breast cancer (BC).
Material and Method: This retrospective cross-sectional study was conducted between January 2010 and January 2015 at a tertiary hospital in Turkey. A total of 280 patients who underwent surgery for histologically diagnosed invasive epithelial BC were included in the study.
Results: The mean age of the patients was 53.31±12.58 years. The median follow-up time was 83 (IQR: 56.5–102) months. According to the results we found, there was a statistically significant positive correlation between progesterone receptor (PR) negativity and RDW values (p=0.015). In addition, the RDW values of patients with perineural invasion (PNI) were found to be significantly higher than those without (p=0.036).
Conclusion: When the results of our study are evaluated together with prior reports, it can be said that higher preoperative RDW is associated with poor prognosis. When RDW is evaluated together with other possible prognostic factors, such as PNI and PR status, it has the potential to be a new, easily applicable and accurate marker to assess prognosis in patients with invasive epithelial BC.
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Affiliation(s)
| | | | | | - Bülent ÜNAL
- ISTANBUL AYDIN UNIVERSITY, SCHOOL OF MEDICINE
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11
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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: 1.3] [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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12
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A Fast and Reliable Method to Interpret Short-Term Mortality in Perforated Peptic Ulcer: Red Cell Distribution Width is Sensitive and Specific. Surg Res Pract 2021; 2021:5542619. [PMID: 34056058 PMCID: PMC8149252 DOI: 10.1155/2021/5542619] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2021] [Accepted: 05/05/2021] [Indexed: 11/25/2022] Open
Abstract
Introduction Peptic ulcer is an important health problem worldwide with a prevalence of around 5%. Peptic ulcer perforation is a potentially mortal complication of peptic ulcer disease. We aimed to investigate the potential use of red cell distribution width as a prognostic marker in peptic ulcer perforation. Methods The files, operation notes, biochemical and hematological parameters, and prognosis of patients who were operated for a peptic ulcer perforation were reviewed in a retrospective cohort study. The relation of red cell distribution width (RDW) to main outcome in-hospital mortality was assessed. Results The mean age of the 172 patients was 40 ± 17.89. There were 158 (92%) males and 14 (8%) females. The in-hospital mortality was 8.7% (15/172). The median RDW in the group with mortality was 15.00 (interquartile range (IQR): 14.30–17.20) compared with the median RDW in the group with no mortality as 13.2 (IQR: 12.80–14.00, p ≤ 0.001). Receiver operator characteristic curves were plotted for RDW to identify nonsurvivors and yielded a significant area under the curve as 0.812 (95% confidence interval: 0.682–0.942). The sensitivity and specificity of RDW at a cutoff value of 14.25% were calculated with an accuracy of 81.98 (95% confidence interval: 75.40–87.41) as 80.00 (51.91–95.67) and 82.17 (75.27–87.81), respectively. Conclusion Increased RDW may be of use to interpret mortality in patients with peptic ulcer perforation.
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Jia X, Cheng S, Zhang L, Zheng Y, Zou H, Huang S, Wang H, Lu J, Tang D. Elevated Red Blood Cell Distribution Width as a Poor Prognostic Factor in Patients With Hematopoietic Stem Cell Transplantation. Front Oncol 2021; 10:565265. [PMID: 33537231 PMCID: PMC7848151 DOI: 10.3389/fonc.2020.565265] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2020] [Accepted: 11/30/2020] [Indexed: 12/31/2022] Open
Abstract
Red cell distribution width (RDW), a measure of erythrocyte size variability, has been recently reported as an effective prognostic factor in critical illness. Hematopoietic stem cell transplantation (HSCT) has become the first choice of most patients with hematological malignancies. The aim of this study was to assess the changes of RDW in patients with HSCT and analyze the relationship between RDW and HSCT. In this study, we retrospectively enrolled 114 hematopoietic stem cell transplant patients during the period from 2015 to 2019. Logistic regression and Kaplan-Meier survival analysis were used for retrospective analysis. Multivariate analysis suggested that patients with elevated RDW (>14.5%) at three months post-transplantation have a poor clinical outcome compared with those with normal RDW ≤14.5% [odds ratio (OR) 5.12; P = 0.002]. Kaplan-Meier method analysis demonstrated that patients with elevated RDW levels (>14.5%) after hematopoietic stem cell transplantation experienced shorter progression-free survival compared to those with normal RDW levels (P = 0.008). Our study demonstrated that RDW could be an easily available and potential predictive biomarker for risk stratification in patients with HSCT. Further prospective studies are determined to confirm the prognostic value of RDW in HSCT patients.
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Affiliation(s)
- Xiaojiong Jia
- Department of Laboratory Medicine, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Si Cheng
- Department of Orthopaedics, The Second Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Long Zhang
- Department of Urinary Surgery, People's Hospital of Jiulongpo District, Chongqing, China
| | - Yuan Zheng
- Department of Laboratory Medicine, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Hua Zou
- Department of Laboratory Medicine, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Shifeng Huang
- Department of Laboratory Medicine, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Hongxu Wang
- Department of Laboratory Medicine, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Juan Lu
- Department of Otolaryngology-Head and Neck Surgery, Nanfang Hospital, Southern Medical University, Guangzhou, China
| | - Dijiao Tang
- Department of Laboratory Medicine, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
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Increased red cell distribution width predicts severity of drug-induced liver injury: a retrospective study. Sci Rep 2021; 11:773. [PMID: 33436893 PMCID: PMC7803943 DOI: 10.1038/s41598-020-80116-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2020] [Accepted: 12/16/2020] [Indexed: 11/25/2022] Open
Abstract
We used a retrospective study design to evaluated the predictive value of red cell distribution width (RDW) for drug-induced liver injury (DILI) severity in Chinese patients with liver biopsy to assist with early DILI management. We included 164 DILI patients with complete laboratory information and medical history. We compared outcomes of 36 patients with severe DILI with outcomes of a control group of 128 patients with mild-to-moderate DILI. Multivariate analyses of risk factors for severe liver injury in Chinese patients with DILI revealed an estimated adjusted odds ratio (AOR) (95% CI) of 4.938 (1.088–22.412) in patients with drinking. Risk for serious liver injury was also increased significantly in patients with dyslipidemia [AOR (95% CI) 3.926 (1.282–12.026)], higher serum total bile acid (TBA) levels [AOR (95% CI) 1.014 (1.009–1.020)] and higher RDW [AOR (95% CI) 1.582 (1.261–1.986)]. The result for area under the curve of 0.905 for TBA levels indicated this variable had high diagnostic performance for predicting DILI severity. Based on an area under the curve value of 0.855, RDW also had superior diagnostic performance in prediction of DILI severity. This performance was not significantly different compared with TBA and was superior compared with other variables, which had area under values ranging from poor to failure (0.527–0.714).The risk for severe DILI was associated with drinking, dyslipidemia, higher TBA levels and RDW values. This study found that RDW and TBA levels were predictors of DILI severity in Chinese patients.
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The Ratio of the Hemoglobin to Red Cell Distribution Width Combined with the Ratio of Platelets to Lymphocytes Can Predict the Survival of Patients with Gastric Cancer Liver Metastasis. BIOMED RESEARCH INTERNATIONAL 2021; 2021:8729869. [PMID: 33506035 PMCID: PMC7814956 DOI: 10.1155/2021/8729869] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/10/2020] [Revised: 12/09/2020] [Accepted: 12/15/2020] [Indexed: 02/06/2023]
Abstract
Background Hemoglobin/red cell distribution width (HR) and platelet/lymphocyte (PLR) ratios are considered effective prognostic markers in various cancers. We have proposed a new prognostic parameter: HR+PLR. The aim of this study is to explore the prognostic value of the HR+PLR scoring system in patients with gastric cancer liver metastasis. Methods This study retrospectively analyzed the clinical data of 306 patients with gastric cancer liver metastases admitted to our hospital from 2007 to 2014. According to the size of HR value and PLR value, we will divide the patients into three groups, namely, HR+PLR: (1) 0 points: HR > 1.02 and PLR < 128; (2) 1 point: HR > 1.02 and PLR > 128 and HR < 1.02 and PLR < 128; and (3) 2 points: HR < 1.02 and PLR > 128. Results The HR+PLR score was statistically different from age (P = 0.049), T stage (P < 0.001), N stage (P = 0.017), number of liver metastases (P = 0.018), gastrectomy (P < 0.001), hepatectomy (P = 0.001), peritoneal metastasis (P = 0.012), prognostic nutritional index (PNI) (P = 0.028), and neutrophil/lymphocyte ratio (NLR) (P = 0.045). The HR+PLR scoring system has a higher area under the ROC curve (AUC value) than PNI, PLR, HR, and PLR (AUC = 0.798, P < 0.001). In multivariate analysis, gastrectomy (P = 0.001), hepatectomy (P < 0.001), chemotherapy (P = 0.014), and HR+PLR score (P < 0.001) were considered independent prognostic factors. Conclusion For patients with gastric cancer liver metastasis, the HR+PLR score is a simple, reliable, and economic prognostic marker.
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Zhang D, Zhang S, Wang L, Pan T, Zhong X. The relationship between red blood cell distribution and islet β-cell function indexes in patients with type 2 diabetes. BMC Endocr Disord 2021; 21:7. [PMID: 33413319 PMCID: PMC7791877 DOI: 10.1186/s12902-020-00668-4] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/17/2020] [Accepted: 12/16/2020] [Indexed: 01/19/2023] Open
Abstract
BACKGROUND Red cell distribution width (RDW) is a predicter of infections, cancer and diabetes. However, the relationship between RDW and β-cell function and insulin resistance remains unclear in patients with type 2 diabetes mellitus (T2DM). The aim of the study was to explore the relationship between RDW and β-cell function in patients with T2DM. METHODS A total of 559 T2DM patients were enrolled in this cross-sectional study. Patients were divided into three groups according to RDW tertiles. Clinical and biochemical characteristics such as age, duration of diabetes, blood pressure, RDW, glycosylated hemoglobin A1c (HbA1c), C-peptide and lipid profiles were collected. Homeostasis model assessment of insulin resistance (HOMA2IR) and homeostasis model assessment of β-cell function (HOMA2%B) were assessed using homeostasis model assessment (HOMA) based on fasting blood glucose (FBG) and fasting C-peptide index (FCPI). Correlations and multiple linear regressions were performed to explore the association between RDW and islet function indexes in total population and in different gender subgroups. RESULTS The HOMA2%B gradually increased according to RDW tertiles (lowest, second, highest RDW tertiles; 47.1(32.9-75.4), 54.05(34.1-81), and 57.9(38.65-95.4), respectively; P = 0.036). Correlation analysis indicated that there were significant correlations between RDW and age, diabetes duration, diastolic blood pressure (DBP), triglycerides (TG), aspartate transaminase (AST), FBG, HbA1c and HOMA2%B in all subjects. In male subjects, RDW correlated positively with age, high-density lipoprotein cholesterol (HDL) and AST, and it correlated negatively with body mass index (BMI), DBP and TG. In female subjects, RDW correlated positively with age, duration, serum creatinine (Cr), FCPI and HOMA2%B, and it correlated negatively with alanine transaminase (ALT), FBG and HbA1c. Multiple linear regressions indicated that RDW was significantly correlated with HOMA2%B and HbA1c in the total population in both unadjusted and adjusted analysis. This finding could be reproduced in the subgroup of men for HOMA2%B only and in women for HbA1c only. CONCLUSIONS RDW is associated with β-cell function assessed by HOMA2%B after adjusting for covariates in male T2DM patients.
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Affiliation(s)
- Deyuan Zhang
- Department of Endocrinology, The Second Affiliated Hospital of Anhui Medical University, Hefei, Anhui Province, People's Republic of China
| | - Siqi Zhang
- Department of Endocrinology, The Second Affiliated Hospital of Anhui Medical University, Hefei, Anhui Province, People's Republic of China
| | - Lifang Wang
- Clinical Epidemiology Research Center, Beijing Jishuitan Hospital, Beijing, People's Republic of China
| | - Tianrong Pan
- Department of Endocrinology, The Second Affiliated Hospital of Anhui Medical University, Hefei, Anhui Province, People's Republic of China.
| | - Xing Zhong
- Department of Endocrinology, The Second Affiliated Hospital of Anhui Medical University, Hefei, Anhui Province, People's Republic of China.
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Li X, Xu H, Gao P. Red Blood Cell Distribution Width-to-Platelet Ratio and Other Laboratory Indices Associated with Severity of Histological Hepatic Fibrosis in Patients with Autoimmune Hepatitis: A Retrospective Study at a Single Center. Med Sci Monit 2020; 26:e927946. [PMID: 33180750 PMCID: PMC7670828 DOI: 10.12659/msm.927946] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
Background This retrospective study at a single center aimed to evaluate the role of the red blood cell distribution width (RDW)-to-platelet ratio and other laboratory indices associated with the severity of histological hepatic fibrosis on liver biopsy in patients with autoimmune hepatitis (AIH). Material/Methods We retrospectively reviewed records from 2097 adult patients who had liver biopsies. Of these patients, data from 72 with AIH and 164 with drug-induced liver injury (DILI) with complete laboratory information and medical histories were included in the analysis. Results We found that compared with patients with DILI, patients with AIH had higher alkaline phosphatase, globulin, and total bile acid levels. Multivariate analyses of risk factors for AIH-associated advanced liver fibrosis in Chinese patients revealed an estimated adjusted odds ratio (AOR) (95% CI) of 1.609 (1.028–2.517) in patients with higher immunoglobulin A (IgA) levels. Patients with higher gamma-glutamyl transpeptidase (GGT)-to-platelet ratio (GPR) values had a significantly higher risk of serious liver fibrosis than patients with lower GPR values. Advanced fibrosis risk was higher in patients with higher RPR values than in patients with lower RPR values [AOR (95% CI): 25.507 (2.934–221.784)]. The result for area under the curve (0.821) analysis for lnRPR levels indicated this variable had high diagnostic performance for predicting advanced AIH-related fibrosis. Conclusions The degree of histological liver fibrosis in patients with AIH was significantly associated with an increased red blood cell distribution width-to-platelet ratio, GPR, and increased serum levels of IgA.
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Affiliation(s)
- Xu Li
- Department of Hepatology, The First Hospital of Jilin University, Jilin University, Changchun, Jilin, China (mainland)
| | - Hongqin Xu
- Department of Hepatology, The First Hospital of Jilin University, Jilin University, Changchun, Jilin, China (mainland).,Jilin Province Key Laboratory of Infectious Disease, Laboratory of Molecular Virology, Changchun, Jilin, China (mainland)
| | - Pujun Gao
- Department of Hepatology, The First Hospital of Jilin University, Jilin University, Changchun, Jilin, China (mainland)
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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: 20] [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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Red cell differential width (RDW) as a predictor of survival outcomes with palliative and adjuvant chemotherapy for metastatic penile cancer. Int Urol Nephrol 2020; 52:2301-2306. [PMID: 32705478 PMCID: PMC7655563 DOI: 10.1007/s11255-020-02565-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2020] [Accepted: 07/06/2020] [Indexed: 11/29/2022]
Abstract
Purpose Red cell distribution width (RDW) measures red cells’ size variability. Metastatic penile cancer displays poor chemotherapy response. As no validated prognostic predictor exists, we investigated whether RDW correlates independently with survival outcomes in metastatic penile cancer treated by chemotherapy. Methods Electronic chemotherapy files of patients with metastatic penile cancer (M1 or N3) from a large academic supra-regional centre were retrospectively analysed between 2005 and 2018. Patients were stratified into RDW > 13.9% and < 13.9%, as per published data on RDW in renal cell carcinoma. Survival time was calculated from the date of chemotherapy initiation until the date of death. Results 58 patients were analysed. The RDW-high group (n = 31) had a poorer survival than the RDW-low group (n = 27). Median overall survival (mOS) in all patients was 19.0 months (95% CI 13.1–24.9). mOS for RDW-high was 15.0 months (95% CI 10.1–19.9) and 37.0 months (95% CI 32.3–43.1) for RDW-low. Kaplan–Meier curves showed a clear disparity in survival (log rank p = 0.025). Cox proportional hazard ratio for death, corrected for T-stage, grade, age and deprivation score was 0.43 (p = 0.04). Sub-analysis of the M1 patients showed mOS in RDW-high of 17 m (95% CI 11.6–22.4) vs. NR; HR for death of 0.42. N3 patients’ mOS in RDW-high cohort was 30 months (95% CI 4.5–55.9) vs. 13 months (95% CI 1.8–24.2) in RDW-low; HR for death was 0.30. Conclusion RDW correlates independently with survival outcomes in metastatic penile cancer and may act as a potential predictor of survival outcomes for patients with metastatic penile cancer receiving chemotherapy.
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Aboulthana WM, Ibrahim NES, Osman NM, Seif MM, Hassan AK, Youssef AM, El-Feky AM, Madboli AA. Evaluation of the Biological Efficiency of Silver Nanoparticles Biosynthesized Using Croton tiglium L. Seeds Extract against Azoxymethane Induced Colon Cancer in Rats. Asian Pac J Cancer Prev 2020; 21:1369-1389. [PMID: 32458646 PMCID: PMC7541879 DOI: 10.31557/apjcp.2020.21.5.1369] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2020] [Indexed: 12/21/2022] Open
Abstract
BACKGROUND Colorectal cancer (CRC) is considered as the most common type of gastrointestinal cancers. Chemotherapy became limited due to the adverse side effects. Therefore, the most effective Croton tiglium extract was selected to be incorporated by silver nanoparticles (Ag-NPs) then evaluated against colon cancer induced by azoxymethane (AOM) in rats. METHODS Different hematological and biochemical measurements were quantified in addition to markers of oxidative stress. Specific tumor and inflammatory markers were assayed. Colonic tissues were examined histopathologically in addition to immunohistochemistry (IHC). Native proteins and isoenzymes patterns were electrophoretically assayed beside expression of Tumor Protein P53 (TP53) and Adenomatous Polyposis Coli (APC) genes in colonic tissues. RESULTS It was found that AOM caused significant (P≤0.05) elevation in the hematological and biochemical measurements. C. tiglium nano-extract restored these measurements to normalcy. Tumor and inflammatory markers elevated significantly (P≤0.05) in sera of AOM induced colon cancer group in addition to increasing peroxidation products with decline in antioxidant enzymes activities in colon tissues. Nano-extract restored these measurements to normalcy in post-treated group. Histopathological study revealed that nano-extract minimized severity of inflammatory reactions in all nano-extract treated groups and prevented anti-Keratin 20 antibody expression in post-treated group. The lowest similarity index (SI%) values were noticed with electrophoretic protein (SI=71.43%), lipid (SI=0.00%) and calcium (SI=75.00%) moieties of protein patterns, catalase (SI=85.71%), peroxidase (SI=85.71%), α-esterase (SI=50.00%) and β-esterase (SI=50.00%) isoenzymes in colon cancer group. Furthermore, AOM altered the relative quantities of total native bands. The nano-extract prevented the alterations that occurred qualitatively in nano-extract post-treated group and quantitatively in all nano-extract treated groups. Levels of TP53 and APC gene expression increased in AOM injected group and nano-extract restored their levels to normalcy in the post-treated group. CONCLUSION C. tiglium nano-extract exhibited ameliorative effect against the biochemical and molecular alterations induced by AOM in nano-extract post-treated group.
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Affiliation(s)
- Wael Mahmoud Aboulthana
- Biochemistry Department, Genetic Engineering and Biotechnology Division, National Research Centre, Dokki, Giza, Egypt.
- For Correspondence:
| | - Noha El-Sayed Ibrahim
- Microbial Biotechnology Department, Genetic Engineering and Biotechnology Division, National Research Centre, Dokki, Giza, Egypt.
| | - Noha Mohamed Osman
- Cell Biology Department, Genetic Engineering and Biotechnology Division, National Research Centre, Dokki, Giza, Egypt.
| | - Mohamed Mahmoud Seif
- Toxicology and Food contaminants, Food Industry and Nutrition Division, National Research Center, Dokki, Giza, Egypt.
| | - Amgad Kamal Hassan
- Biochemistry Department, Genetic Engineering and Biotechnology Division, National Research Centre, Dokki, Giza, Egypt.
| | | | - Amal Mostafa El-Feky
- Pharmacognosy Department, Pharmaceutical and Drug Industries Research Division, National Research Centre, Dokki, Giza, Egypt.
| | - A A Madboli
- Animal Reproduction and Artificial Insemination Department, Veterinary Division, National Research Centre, Dokki, Giza, Egypt .
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Liu S, Shi J, Guo H, Xu F, Wei M, Sun K, Chen Y. Prognostic Significance Of The Inflammatory Index-Based Scoring System In Patients Preliminarily Diagnosed With Multiple Myeloma In The Bortezomib-Based Chemotherapy Era. Cancer Manag Res 2019; 11:9409-9420. [PMID: 31807070 PMCID: PMC6842606 DOI: 10.2147/cmar.s227671] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2019] [Accepted: 10/10/2019] [Indexed: 12/24/2022] Open
Abstract
Purpose Red blood cell distribution width (RDW), neutrophil-to-lymphocyte ratio (NLR), and platelet count (PLT) have been reported to be associated with the prognosis of malignancies; this study aimed to evaluate the prognostic significance of the inflammatory prognostic scoring index (IPSI), comprised of RDW, N LR, and PLT for overall survival (OS) in newly diagnosed multiple myeloma patients in the bortezomib-based chemotherapy era. Patients and methods The prognostic significance of variables associated with the OS of 175 newly diagnosed multiple myeloma patients was evaluated through univariate and multivariate analyses. The cut-off values of RDW, NLR, and PLT were obtained from references. Patients with high RDW (RDW>14) were given a score of 1; patients with high NLR (NLR>2) or low PLT (PLT≤150) were given a score of 2. According to the obtained scores, the inflammatory prognostic scoring index (IPSI) was formed, in which patients were grouped into high-risk group (4–5 points), intermediate-risk group (3 points) and low-risk group (0–2 points). Results OS varied significantly in different IPSI groups (P< 0.001). On multivariate analysis, the IPSI was an independent prognostic factor for OS (intermediate-risk group HR 2.89, 95% CI 1.60–5.22, high risk-group HR 14.50, 95% CI 7.26–28.93, P<0.001). Importantly, with IPSI as supplement to the International Staging System (ISS), a significant difference in OS was observed among IPSI subgroups (ISS I, P<0.001; ISS II, P=0.008; ISS III, P<0.001). Conclusion The IPSI, comprised of RDW, NLR, and PLT, played specific role in the prognosis of patients preliminarily diagnosed with multiple myeloma in the bortezomib-based chemotherapy era and could be a beneficial supplement for ISS staging.
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Affiliation(s)
- Siwei Liu
- Department of Hematology, Henan University People's Hospital, School of Clinical Medicine, Henan University, Zhengzhou 450003, Henan, People's Republic of China
| | - Jie Shi
- Department of Hematology, Henan Provincial People's Hospital, Zhengzhou 450003, Henan, People's Republic of China
| | - Honggang Guo
- Department of Hematology, Henan Provincial People's Hospital, Zhengzhou 450003, Henan, People's Republic of China
| | - Fangfang Xu
- Department of Hematology, Henan Provincial People's Hospital, Zhengzhou 450003, Henan, People's Republic of China
| | - Min Wei
- Department of Hematology, Henan University People's Hospital, School of Clinical Medicine, Henan University, Zhengzhou 450003, Henan, People's Republic of China
| | - Kai Sun
- Department of Hematology, Henan Provincial People's Hospital, Zhengzhou 450003, Henan, People's Republic of China
| | - Yuqing Chen
- Department of Hematology, Henan Provincial People's Hospital, Zhengzhou 450003, Henan, People's Republic of China
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Relationship between red cell distribution width and prognosis in patients with breast cancer after operation: a retrospective cohort study. Biosci Rep 2019; 39:BSR20190740. [PMID: 31262969 PMCID: PMC6629944 DOI: 10.1042/bsr20190740] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2019] [Revised: 06/17/2019] [Accepted: 06/25/2019] [Indexed: 12/25/2022] Open
Abstract
We retrospectively enrolled 825 breast cancer patients, who was primarily diagnosed in our hospital between January 2009 and December 2014 and explored the relationship between red blood cell distribution width (RDW) and long-term prognosis in patients with breast cancer. There were 412 patients with high RDW (RDW > 13.82) and 413 patients with low RDW (RDW ≤ 13.82). Compared with low RDW group, the high w group has large tumor size (the rate of tumor size >2 cm: 60.7 vs 44.8%, P=0.013). The rate of lymph node metastases was higher in the high RDW group thaten that in the low RDW group (62.1 vs 45.8%, P=0.000). RDW was positively associated with tumor stage. The high RDW tended to be advanced stage (P=0.000). Compared with low RDW group, the high RDW group tended to be higher lymphocyte count (P=0.004), elevated fibrinogen (P=0.043), and elevated high-sensitivity C-reactive protein (P=0.000). The Kaplan-Meier analysis indicated elevated RDW was positively associated with disease-free survival (DFS) (P=0.004) and overall survival (OS) (P=0.011). The multivariate Cox regression analysis indicated that the high RDW group had poorer OS (Hazard risk [HR] = 2.43; 95% CI: 1.62-3.21; P=0.024) and DFS (HR = 1.89; 95% CI: 1.28-3.62; P=0.000) compared with low RDW group. The present study found that high pretreatment RDW levels in breast cancer patients were associated with poor OS and DFS. RDW could be a potential predictive factor in differential diagnosis of poor prognosis from all patients.
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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: 7.3] [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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Yogo T, Okazuka K, Nashimoto J, Uto Y, Sato K, Miyazaki K, Ogura M, Yoshiki Y, Abe Y, Tsukada N, Ishida T, Suzuki K. Red blood cell distribution width is a simple and novel biomarker for survival in light-chain amyloidosis. Int J Hematol 2019; 110:431-437. [PMID: 31236823 DOI: 10.1007/s12185-019-02692-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2019] [Revised: 06/18/2019] [Accepted: 06/18/2019] [Indexed: 10/26/2022]
Abstract
Red blood cell distribution width (RDW) has been used for the differential diagnosis of anemia, but high RDW may also be associated with several human disorders. We evaluated the prognostic relevance of RDW in patients with light-chain (AL) amyloidosis. We retrospectively analyzed all patients with AL amyloidosis who were newly diagnosed at the Japanese Red Cross Medical Center between December 2011 and June 2018. RDW was evaluated in 94 patients; 48% (n = 45) of patients had a high RDW (≥ 13.8%) and 52% (n = 49) had a low RDW (< 13.8%). Overall survival (OS) was significantly lower in patients with a high RDW (P < 0.001). On multivariate analysis, increased RDW was an independent predictor for OS. Even in patients without cardiac amyloidosis, the OS was significantly lower in the high-RDW group (P = 0.0064). The survival rate of high-RDW patients without cardiac involvement was as poor as that of patients with cardiac involvement. In addition, in patients with revised Mayo stage I or a normal level of N-terminal pro-B-type natriuretic peptide, high RDW was negatively correlated with OS (P = 0.0086, 0.025). RDW is a simple and strong predictor of early death, and is a prognostic biomarker in patients with AL amyloidosis without cardiac involvement.
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Affiliation(s)
- Takao Yogo
- Department of Hematology, Japanese Red Cross Medical Center, 4-1-22 Hiroo, Shibuya-ku, Tokyo, Japan.
| | - Kiyoshi Okazuka
- Department of Hematology, Japanese Red Cross Medical Center, 4-1-22 Hiroo, Shibuya-ku, Tokyo, Japan
| | - Junichiro Nashimoto
- Department of Hematology, Japanese Red Cross Medical Center, 4-1-22 Hiroo, Shibuya-ku, Tokyo, Japan
| | - Yui Uto
- Department of Hematology, Japanese Red Cross Medical Center, 4-1-22 Hiroo, Shibuya-ku, Tokyo, Japan
| | - Kota Sato
- Department of Hematology, Japanese Red Cross Medical Center, 4-1-22 Hiroo, Shibuya-ku, Tokyo, Japan
| | - Kanji Miyazaki
- Department of Hematology, Japanese Red Cross Medical Center, 4-1-22 Hiroo, Shibuya-ku, Tokyo, Japan
| | - Mizuki Ogura
- Department of Hematology, Japanese Red Cross Medical Center, 4-1-22 Hiroo, Shibuya-ku, Tokyo, Japan
| | - Yumiko Yoshiki
- Department of Hematology, Japanese Red Cross Medical Center, 4-1-22 Hiroo, Shibuya-ku, Tokyo, Japan
| | - Yu Abe
- Department of Hematology, Japanese Red Cross Medical Center, 4-1-22 Hiroo, Shibuya-ku, Tokyo, Japan
| | - Nobuhiro Tsukada
- Department of Hematology, Japanese Red Cross Medical Center, 4-1-22 Hiroo, Shibuya-ku, Tokyo, Japan
| | - Tadao Ishida
- Department of Hematology, Japanese Red Cross Medical Center, 4-1-22 Hiroo, Shibuya-ku, Tokyo, Japan
| | - Kenshi Suzuki
- Department of Hematology, Japanese Red Cross Medical Center, 4-1-22 Hiroo, Shibuya-ku, Tokyo, Japan
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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: 1.0] [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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The Association between Red Blood Cell Distribution Width and Mortality in Critically Ill Patients with Acute Kidney Injury. BIOMED RESEARCH INTERNATIONAL 2018; 2018:9658216. [PMID: 30345313 PMCID: PMC6174796 DOI: 10.1155/2018/9658216] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/11/2018] [Revised: 08/08/2018] [Accepted: 08/19/2018] [Indexed: 12/25/2022]
Abstract
Background Several investigators have sought risk factors for mortality in acute kidney injury (AKI). However, no epidemiological studies have investigated the impact of red blood cell distribution width (RDW) on prognosis for critically ill patients with AKI. The aim of this study was to investigate the association of RDW with mortality in these patients. Methods We analyzed data from the MIMIC-III. RDW was measured upon ICU admission. The association between RDW and mortality of AKI was determined using a multivariate logistic regression and was expressed as the adjusted odds ratio with associated 95% confidence interval (CI). We also conducted subgroup analyses to determine the consistency of this association. Results A total of 14,078 critically ill patients with AKI were eligible for this analysis. In multivariate analysis, adjusted for age and gender and compared with the reference group (RDW 11.1-13.4%) related to hospital mortality, the adjusted ORs (95% CIs) for RDW levels 13.5-14.3%, 14.4-15.6%, and 15.7-21.2% were 1.22 (1.05, 1.43), 1.56 (1.35, 1.81), and 2.66 (2.31, 3.06), respectively. After adjusting for confounding factors, with high RDW linked to an increase in mortality (RDW 15.7-21.2% versus 11.1-13.4%: OR, 1.57; 95% CI, 1.22 to 2.01; P trend <0.0001). A similar trend was observed for 30-day mortality. Conclusions RDW appeared to be an independent prognostic marker in critically ill patients with AKI and higher RDW was associated with increased risk of mortality in these patients.
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Xu WY, Yang XB, Wang WQ, Bai Y, Long JY, Lin JZ, Xiong JP, Zheng YC, He XD, Zhao HT, Sang XT. Prognostic impact of the red cell distribution width in esophageal cancer patients: A systematic review and meta-analysis. World J Gastroenterol 2018; 24:2120-2129. [PMID: 29785080 PMCID: PMC5960817 DOI: 10.3748/wjg.v24.i19.2120] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/07/2018] [Revised: 04/03/2018] [Accepted: 04/15/2018] [Indexed: 02/06/2023] Open
Abstract
AIM To clarify the previous discrepant conclusions, we performed a meta-analysis to evaluate the prognostic value of red cell distribution width (RDW) in esophageal cancer (EC).
METHODS We searched the PubMed, EMBASE, Web of Science and Cochrane Library databases to identify clinical studies, followed by using STATA version 12.0 for statistical analysis. Studies that met the following criteria were considered eligible: (1) Studies including EC patients who underwent radical esophagectomy; (2) studies including patients with localized disease without distant metastasis; (3) studies including patients without preoperative neoadjuvant therapy; (4) studies including patients without previous antiinflammatory therapies and with available preoperative laboratory outcomes; (5) studies reporting association between the preoperative RDW and overall survival (OS)/disease-free survival (DFS)/cancer-specific survival (CSS); and (6) studies published in English.
RESULTS A total of six articles, published between 2015 and 2017, fulfilled the selection criteria in the end. Statistical analysis showed that RDW was not associated with the prognosis of EC patients, irrespective of OS/CSS [hazard ratio (HR) = 1.27, 95% confidence interval (CI): 0.97-1.57, P = 0.000] or DFS (HR = 1.42, 95%CI: 0.96-1.88, P = 0.000). Subgroup analysis indicated that elevated RDW was significantly associated with worse OS/CSS of EC patients when RDW > 13% (HR = 1.45, 95%CI: 1.13-1.76, P = 0.000), when the patient number ≤ 400 (HR = 1.45, 95%CI: 1.13-1.76, P = 0.000) and when the study type was retrospective (HR = 1.42, 95%CI : 1.16-1.69, P = 0.000).
CONCLUSION Contrary to our general understanding, this meta-analysis revealed that RDW cannot serve as an indicator of poor prognosis in patients with EC. However, it may still be a useful predictor of unfavorable prognosis using an appropriate cut-off value.
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Affiliation(s)
- Wei-Yu Xu
- Department of Liver Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100730, China
| | - Xiao-Bo Yang
- Department of Liver Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100730, China
| | - Wen-Qin Wang
- Department of General Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100730, China
| | - Yi Bai
- Department of Liver Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100730, China
| | - Jun-Yu Long
- Department of Liver Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100730, China
| | - Jian-Zhen Lin
- Department of Liver Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100730, China
| | - Jian-Ping Xiong
- Department of Liver Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100730, China
| | - Yong-Chang Zheng
- Department of Liver Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100730, China
| | - Xiao-Dong He
- Department of General Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100730, China
| | - Hai-Tao Zhao
- Department of Liver Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100730, China
| | - Xin-Ting Sang
- Department of Liver Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100730, China
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Ai L, Mu S, Hu Y. Prognostic role of RDW in hematological malignancies: a systematic review and meta-analysis. Cancer Cell Int 2018; 18:61. [PMID: 29713244 PMCID: PMC5914059 DOI: 10.1186/s12935-018-0558-3] [Citation(s) in RCA: 59] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2018] [Accepted: 04/16/2018] [Indexed: 01/28/2023] Open
Abstract
Background Red blood cell distribution width (RDW), a biomarker for discrimination of anemia, has been recently identified as a prognostic factor in various types of cancer. Here we performed a meta-analysis in order to assess the correlation between RDW and the survival outcomes in patients with hematologic malignances. Patients/methods We systematically searched PubMed, Embase, and ISI Web of Science for relevant studies, to investigate the prognostic significance of RDW in hematological malignancies. Odds ratios or hazards ratios (HRs) with corresponding 95% confidence intervals (CIs) are pooled to estimate the association between RDW and clinicopathological parameters of patients with hematologic malignances. Results Seven trials with 1031 patients suffering from hematological malignancies were included in the meta-analysis, and the results indicated that increased pretreatment RDW predicted poor overall survival (HR = 2.35, 95% CI 1.70–3.24), poor progress-free survival (HR = 2.44, 95% CI 1.70–3.49) and poor event-free survival (EFS) (HR = 3.15, 95% CI 1.59–6.25). Furthermore, the similar results were observed in subgroup analysis stratified by cancer type, such as multiple myeloma, and diffuse large B cell lymphoma, etc. Conclusions As for hematologic malignances, patients with higher RDW are more likely to have poorer prognosis than those with lower RDW.
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Affiliation(s)
- Lisha Ai
- Institute of Hematology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430022 China
| | - Shidai Mu
- Institute of Hematology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430022 China
| | - Yu Hu
- Institute of Hematology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430022 China
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Yin Y, Ye S, Wang H, Li B, Wang A, Yan W, Dou J, Mu Y. Red blood cell distribution width and the risk of being in poor glycemic control among patients with established type 2 diabetes. Ther Clin Risk Manag 2018; 14:265-273. [PMID: 29497303 PMCID: PMC5818876 DOI: 10.2147/tcrm.s155753] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
Background The red cell distribution width (RDW) has been shown to be associated with the incidence and complications of type 2 diabetes (T2D). However, the relevance of RDW with the risk of being in poor glycemic control among patients with established T2D is largely overlooked. Methods A total of 702 T2D participants from the REACTION study were enrolled in this study. Blood routine index, fasting plasma glucose, hemoglobin A1c and lipid profile data were available for all of the enrolled population. Results The univariate logistic analysis revealed a significant association between RDW and the risk of being in poor glycemic control among T2D subjects with an odds ratio (OR) and a 95% confidence interval (CI) of 0.5 and 0.3–0.8, respectively, for the fourth vs the first quartile of RDW. The association strengthened after multivariable adjustment (OR [95% CI]: 0.3 [0.2–0.7]). Interaction and stratified analyses indicated that this association was seen only among T2D subjects with lower body mass index and/or serum lipid levels. Conclusion T2D patients with higher RDW had significantly lower risk of being in poor glycemic control. RDW may contribute to risk assessment for T2D individuals at risk of being in poor glycemic control.
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Affiliation(s)
- Yaqi Yin
- Department of Endocrinology, Chinese PLA General Hospital, Beijing, People's Republic of China
| | - Sisi Ye
- Department of Medical Oncology, Chinese PLA General Hospital, Beijing, People's Republic of China
| | - Haibin Wang
- Department of Endocrinology, Chinese PLA General Hospital, Beijing, People's Republic of China
| | - Bing Li
- Department of Endocrinology, Chinese PLA General Hospital, Beijing, People's Republic of China
| | - Anping Wang
- Department of Endocrinology, Chinese PLA General Hospital, Beijing, People's Republic of China
| | - Wenhua Yan
- Department of Endocrinology, Chinese PLA General Hospital, Beijing, People's Republic of China
| | - Jingtao Dou
- Department of Endocrinology, Chinese PLA General Hospital, Beijing, People's Republic of China
| | - Yiming Mu
- Department of Endocrinology, Chinese PLA General Hospital, Beijing, People's Republic of China
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Prognostic significance of the red blood cell distribution width that maintain at high level following completion of first line therapy in mutiple myeloma patients. Oncotarget 2018. [PMID: 29515796 PMCID: PMC5839377 DOI: 10.18632/oncotarget.24076] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023] Open
Abstract
To investigate the prognostic value of the red blood cell distribution width(RDW) recovery from low levels at diagnosis after completion of first line therapy in mutiple myeloma (MM)patients,we enrolled 78 consecutive patients with MM and followed up from 2005 to 2016 in our hospital. The RDW was measured following completion of first-line therapy.The log-rank test, univariate analysis, and Cox regression analysis were used to evaluate the relationship between RDW and survival. We found that patients with an RDW ≥ 15.5% at diagnosis, as well as at completion of first-line therapy, had significantly lower progression-free survival (PFS) and overall survival(OS) rates than those with an RDW < 15.5%(P < 0.05).Patients with RDW that maintained more than 15.5% upon completion of therapy showed a shorter OS (P < 0.05) and PFS (P < 0.05) compared with patients with an RDW that decreased to a lower level.The multivariate analysis showed that RDW ≥ 15.5% after the completion of first-line therapy were an independent prognostic marker of poorer OS (P = 0.044) and PFS (P = 0.034). Therefore,we demonstrated that RDW at diagnosis, as well as at completion of first-line therapy is an independent predictor for mutiple myeloma patients.RDW maintained at high level, irrespective of whether RDW decreased to the cutoff value predicted an unfavorable prognosis in patients with MM.
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Han F, Shang X, Wan F, Liu Z, Tian W, Wang D, Liu Y, Wang Y, Zhang B, Ju Y. Clinical value of the preoperative neutrophil-to-lymphocyte ratio and red blood cell distribution width in patients with colorectal carcinoma. Oncol Lett 2017; 15:3339-3349. [PMID: 29435077 DOI: 10.3892/ol.2017.7697] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2016] [Accepted: 09/09/2017] [Indexed: 12/13/2022] Open
Abstract
The aim of the present study was to investigate the clinical value of the preoperative neutrophil-to-lymphocyte ratio (NLR) and red blood cell distribution width (RDW) in the peripheral blood of colorectal carcinoma (CRC) patients. Clinical data obtained from 240 patients with CRC undergoing radical surgical resection in Shandong Provincial Hospital Affiliated to Shandong University (Jinan, Shandong, China) between January 2011 and April 2015 were retrospectively analyzed. Data were also collected from 110 patients with colon polyps and 48 healthy volunteers to serve as controls for comparative analysis. The clinicopathological characteristics of the patients in the low and high NLR and RDW groups were compared. The NLR and RDW values were compared prior to and following surgery. Kaplan-Meier analyses and Cox regression modeling were performed to predict overall survival (OS) and disease-free survival (DFS). The NLR and RDW levels in the CRC patients were markedly higher than those in the colon polyp patients and the healthy controls. The optimum NLR and RDW cutoff points for CRC were 2.06 and 13.45%, respectively. Significant differences were detected in tumor location, diameter, degree of differentiation, tumor depth, carcinoembryonic antigen and carbohydrate antigen 199 when comparing the high and low NLR groups (P<0.05). A high RDW was significantly associated with distant metastasis and older age in CRC patients. No significant difference was detected in the NLR and RDW levels of CRC patients prior to and following surgery (P>0.05). CRC patients with an increased RDW had significantly worse OS and DFS rates, particularly those with metastatic CRC (P<0.05). Patients with a high NLR exhibited a reduced DFS time in CRC (P=0.053), although this difference was not significant, and a significantly worse DFS time in metastatic CRC (P=0.047). In conclusion, it is convenient to use preoperative NLR and RDW to predict prognosis following surgery for patients with CRC.
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Affiliation(s)
- Fuyan Han
- Department of Laboratory Medicine, Shandong Provincial Hospital Affiliated to Shandong University, Jinan, Shandong 250021, P.R. China
| | - Xuming Shang
- Department of Laboratory Medicine, Shandong Provincial Hospital Affiliated to Shandong University, Jinan, Shandong 250021, P.R. China
| | - Furong Wan
- Department of Laboratory Medicine, Qianfoshan Hospital Affiliated to Shandong University, Jinan, Shandong 250014, P.R. China
| | - Zhanfeng Liu
- Department of Laboratory Medicine, Shandong Provincial Hospital Affiliated to Shandong University, Jinan, Shandong 250021, P.R. China
| | - Wenjun Tian
- Department of Laboratory Medicine, Shandong Provincial Hospital Affiliated to Shandong University, Jinan, Shandong 250021, P.R. China
| | - Dan Wang
- Department of Pathology, Shandong Provincial Hospital Affiliated to Shandong University, Jinan, Shandong 250021, P.R. China
| | - Yiqing Liu
- Department of Laboratory Medicine, Shandong Provincial Hospital Affiliated to Shandong University, Jinan, Shandong 250021, P.R. China
| | - Yong Wang
- Department of Laboratory Medicine, Shandong Provincial Hospital Affiliated to Shandong University, Jinan, Shandong 250021, P.R. China
| | - Bingchang Zhang
- Department of Laboratory Medicine, Shandong Provincial Hospital Affiliated to Shandong University, Jinan, Shandong 250021, P.R. China
| | - Ying Ju
- Department of Laboratory Medicine, Shandong Provincial Hospital Affiliated to Shandong University, Jinan, Shandong 250021, P.R. China
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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 2017; 8:16027-16035. [PMID: 27926498 PMCID: PMC5362543 DOI: 10.18632/oncotarget.13784] [Citation(s) in RCA: 132] [Impact Index Per Article: 16.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2016] [Accepted: 11/22/2016] [Indexed: 12/24/2022] Open
Abstract
Red blood cell distribution width (RDW), a parameter that used to differentiate the type of anemia for several decades, recent studies suggest it was a prognostic factor in various types of cancer patients. However, the prognostic value of RDW in cancer patients remains controversial. Here, we performed a meta-analysis and systematic review to evaluate the prognostic value of RDW in cancer patients. Relevant studies were picked out from the databases of Web of Science, Embase, Pubmed and Cochrane Library. A total of 16 papers with 4267 patients were included in this meta-analysis, and the combined results indicated that elevated RDW was associated with poor over survival (OS) (HR = 1.47, 95%CI:1.29-1.66), poor cancer-specific survival (CSS) (HR = 1.46, 95%CI:1.08-1.85), poor disease-free survival (DFS) (HR = 1.91, 95%CI:1.27-2.56), poor event-free survival (EFS) (HR = 2.98, 95%CI:0.57-5.39) and poor progress-free survival (PFS) (HR = 3.21, 95%CI:0.33-6.75) after treatment. Furthermore, the similar results were observed in subgroup analysis stratified by cancer type, cutoff value of RDW, sample size and ethnicity. In conclusion, this meta-analysis demonstrated that RDW may be a potential prognostic marker in patients with cancer, and high RDW may also be associated with poor outcomes.
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Affiliation(s)
- Linhui Hu
- Department of Hematology/Hematological Laboratory, The Second Hospital of Anhui Medical University, Hefei, Anhui, People's Republic of China
| | - Manman Li
- Department of Hematology/Hematological Laboratory, The Second Hospital of Anhui Medical University, Hefei, Anhui, People's Republic of China
| | - Yangyang Ding
- Department of Hematology/Hematological Laboratory, The Second Hospital of Anhui Medical University, Hefei, Anhui, People's Republic of China
| | - Lianfang Pu
- Department of Hematology/Hematological Laboratory, The Second Hospital of Anhui Medical University, Hefei, Anhui, People's Republic of China
| | - Jun Liu
- Department of Hematology/Hematological Laboratory, The Second Hospital of Anhui Medical University, Hefei, Anhui, People's Republic of China
| | - Jingxin Xie
- Department of Physiology and Pathophysiology, School of Basic Medical Sciences, Fudan University, Shanghai, People's Republic of China
| | - Michael Cabanero
- University Health Network, University of Toronto, Ontario, Canada
| | - Jingrong Li
- Department of Emergency, The Second Hospital of Anhui Medical university, Hefei, Anhui, People's Republic of China
| | - Ru Xiang
- School of Nursing, Anhui Medical University, Hefei, Anhui, People's Republic of China
| | - Shudao Xiong
- Department of Hematology/Hematological Laboratory, The Second Hospital of Anhui Medical University, Hefei, Anhui, People's Republic of China
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Jung J, Lee H, Yun T, Lee E, Moon H, Joo J, Park WS, Choi M, Lee JO, Lee JS, Eom HS. Prognostic role of the neutrophil-to-lymphocyte ratio in patients with primary central nervous system lymphoma. Oncotarget 2017; 8:74975-74986. [PMID: 29088839 PMCID: PMC5650394 DOI: 10.18632/oncotarget.20480] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2017] [Accepted: 07/16/2017] [Indexed: 12/27/2022] Open
Abstract
Neutrophil-to-lymphocyte ratio (NLR) is one of the parameters of a complete blood cell count (CBC) test and has been reported to be an easily accessible prognostic marker in aggressive cancer, including non-Hodgkin lymphoma (NHL). Primary central nervous system lymphoma (PCNSL) is an extranodal NHL with highly aggressive features. However, the importance of the NLR has never been assessed in PCNSL. This retrospective study enrolled 62 biopsy-proven patients whose baseline NLR was available, and reviewed their medical records to compare both high (≥2.0) and low NLR (<2.0) groups, in terms of clinical characteristics and outcomes. The low NLR group showed significantly better response rates to induction chemotherapy compared to the high NLR group (p=0.041). At a median follow-up of 41.5 months, the high NLR group revealed a significantly worse 3-year overall survival (OS) (42.5 vs. 71.2%; p=0.031) and a worse 3-year progression-free survival (PFS) (37.3 vs. 60.1%; p=0.028). Univariable Cox analysis results showed that a high NLR at diagnosis was a poor prognostic factor for both 3-year OS (HR 2.64, 95% CI 1.06-6.60; p=0.038) and 3-year PFS (HR 2.41, 95% CI 1.07-5.42; p=0.034). However, multivariable analyses adjusting for International Extranodal Lymphoma Study Group (IELSG) score and induction chemotherapy regimen with rituximab, which were strongly prognostic in this study, showed no statistical significance even with the high NLR group's tendency towards a worse 3-year OS (HR 2.36, 95% CI 0.84-6.62, p=0.102) and a worse 3-year PFS (HR 2.28, 95% CI 0.93-5.63, p=0.073). In conclusion, given that NLR is simple and easily obtainable, it might play a potentially prognostic role in PCNSL from early disease onset.
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Affiliation(s)
- Jongheon Jung
- Department of Internal Medicine, National Cancer Center, Goyang, Korea.,Department of Cancer Biomedical Science, Graduate School of Cancer Science and Policy, National Cancer Center, Goyang, Korea
| | - Hyewon Lee
- Department of Internal Medicine, National Cancer Center, Goyang, Korea.,Center for Hematologic Malignancy, National Cancer Center, Goyang, Korea
| | - Tak Yun
- Department of Internal Medicine, National Cancer Center, Goyang, Korea.,Rare Cancers Clinic, Center for Specific Organs Cancer, National Cancer Center, Goyang, Korea
| | - Eunyoung Lee
- Department of Internal Medicine, National Cancer Center, Goyang, Korea.,Center for Hematologic Malignancy, National Cancer Center, Goyang, Korea
| | - Hae Moon
- Department of Internal Medicine, National Cancer Center, Goyang, Korea
| | - Jungnam Joo
- Biometrics Research Branch, Research Institute, National Cancer Center, Goyang, Korea
| | - Weon Seo Park
- Department of Pathology, National Cancer Center, Goyang, Korea
| | - Mihong Choi
- Division of Hematology and Medical Oncology, Department of Internal Medicine, Seoul National University Hospital, Seoul, Korea
| | - Jeong-Ok Lee
- Division of Hematology and Medical Oncology, Department of Internal Medicine, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seoul, Korea
| | - Jong Seok Lee
- Division of Hematology and Medical Oncology, Department of Internal Medicine, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seoul, Korea
| | - Hyeon-Seok Eom
- Department of Internal Medicine, National Cancer Center, Goyang, Korea.,Department of Cancer Biomedical Science, Graduate School of Cancer Science and Policy, National Cancer Center, Goyang, Korea.,Center for Hematologic Malignancy, National Cancer Center, Goyang, Korea
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Liang RF, Li M, Yang Y, Mao Q, Liu YH. Significance of Pretreatment Red Blood Cell Distribution Width in Patients with Newly Diagnosed Glioblastoma. Med Sci Monit 2017; 23:3217-3223. [PMID: 28667816 PMCID: PMC5505574 DOI: 10.12659/msm.905204] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND Red blood cell distribution width (RDW) is a parameter of the complete blood count (CBC) test. Recent evidence suggests that pretreatment RDW is associated with patient survival in various malignant tumors. We explored the association of pretreatment RDW and other red blood cell (RBC) parameters with clinical parameters and assessed their prognostic impact on overall survival (OS) in patients with glioblastoma (GBM). MATERIAL AND METHODS In total, 109 patients with newly diagnosed GBM were retrospectively reviewed. The Cox proportional hazards regression model and Kaplan-Meier method were used to examine the survival function of pretreatment RDW, mean cell volume (MCV), hemoglobin (HGB), mean corpuscular hemoglobin (MCH), mean corpuscular hemoglobin concentration (MCHC), RBC count, and hematocrit (HCT) values in patients with newly diagnosed GBM. RESULTS Univariate analysis showed that MCV, MCHC, and RDW were associated with overall survival (OS). However, only RDW remained significant in multivariate analysis. The Kaplan-Meier survival curves showed that patients belonging to the high-RDW group had a worse median OS (293 days versus 375 days, P=0.023) than those belonging to the low-RDW group. CONCLUSIONS The present study showed that pretreatment RDW was superior to MCV and MCHC as a prognostic predictor of clinical outcome in patients newly diagnosed with GBM. Pretreatment RDW was derived directly from the CBC test, which can be easily performed in clinical practice. Therefore, pretreatment RDW values can provide additional prognostic information for patients with GBM. Further larger and prospective studies are needed to confirm these findings and to investigate the mechanism by which of RDW is associated with prognosis in patients with GBM.
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Affiliation(s)
- Ruo-Fei Liang
- Department of Neurosurgery, West China Hospital, Sichuan University, Chengdu, Sichuan, China (mainland)
| | - Mao Li
- Department of Neurosurgery, West China Hospital, Sichuan University, Chengdu, Sichuan, China (mainland)
| | - Yuan Yang
- Department of Neurosurgery, West China Hospital, Sichuan University, Chengdu, Sichuan, China (mainland)
| | - Qing Mao
- Department of Neurosurgery, West China Hospital, Sichuan University, Chengdu, Sichuan, China (mainland)
| | - Yan-Hui Liu
- Department of Neurosurgery, West China Hospital, Sichuan University, Chengdu, Sichuan, China (mainland)
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Zhou S, Fang F, Chen H, Zhang W, Chen Y, Shi Y, Zheng Z, Ma Y, Tang L, Feng J, Zhang Y, Sun L, Chen Y, Liang B, Yu K, Jiang S. Prognostic significance of the red blood cell distribution width in diffuse large B-cell lymphoma patients. Oncotarget 2017; 8:40724-40731. [PMID: 28388534 PMCID: PMC5522205 DOI: 10.18632/oncotarget.16560] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2016] [Accepted: 03/09/2017] [Indexed: 12/11/2022] Open
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.
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Affiliation(s)
- Shujuan Zhou
- Department of Hematology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, P.R. China
| | - Fang Fang
- Department of Hematology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, P.R. China
| | - Huiyao Chen
- Department of Hematology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, P.R. China
| | - Wei Zhang
- Department of Hematology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, P.R. China
| | - Yang Chen
- Department of Hematology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, P.R. China
| | - Yifen Shi
- Department of Hematology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, P.R. China
| | - Zhouyi Zheng
- Department of Hematology and oncology, Traditional Chinese Medical Hospital of Zhuji, Shaoxing, Zhejiang, P.R. China
| | - Yongyong Ma
- Department of Hematology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, P.R. China
| | - Liyuan Tang
- Department of Hematology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, P.R. China
| | - Jianhua Feng
- Department of Hematology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, P.R. China
| | - Yu Zhang
- Department of Hematology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, P.R. China
| | - Lan Sun
- Department of Hematology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, P.R. China
| | - Yi Chen
- Department of Hematology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, P.R. China
| | - Bin Liang
- Department of Hematology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, P.R. China
| | - Kang Yu
- Department of Hematology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, P.R. China
| | - Songfu Jiang
- Department of Hematology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, P.R. China
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Guzel D, Yazici AB, Yazici E, Erol A. Alterations of the hematologic cells in synthetic cannabinoid users. J Clin Lab Anal 2017; 31. [PMID: 28169460 DOI: 10.1002/jcla.22131] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2016] [Accepted: 12/12/2016] [Indexed: 12/22/2022] Open
Abstract
BACKGROUND Functions, morphology, distributions, and index of the circulating cells are the most useful parameters that indicate various inflammatory and toxic conditions. The aim of this study was to investigate the clinical significance of these parameters in patients diagnosed with (synthetic) cannabis use disorder. METHODS This study included a total of 40 patients in the study group (SG) with synthetic cannabis use; and 40 healthy individuals as the control group (CG). Participants, who had hematological disorders and other chronic diseases, were excluded from the study. All hematological parameters of SG were compared with CG. Neutrophil/lymphocyte ratio (NLR) and platelet/lymphocyte ratio (PLR) values were calculated and compared between groups. RESULTS There were statistically significant differences between the groups in terms of WBC, MCH, RDW, MCV, MPV, and NEU, LYM%, MONO% parameters (P<.05). MPW and LYM% were significantly lower in SG compared to CG. WBC, MCH, RDW, MCV, MPV, MONO, and NEU parameters were significantly higher in SG compared to CG (P<.05). UIBC and TIBC levels were significantly higher in SG compared to CG (P<.001). Although there was statistically significant difference between groups in terms of NLR, there was no significant difference for PLR values. CONCLUSION Our data suggested that chronic use of cannabinoids can lead to deterioration of hematopoietic cells. Chronic use of cannabinoids was consistent with subthreshold/subclinical megaloblastic anemia with iron deficiency. Inflammatory cells, especially neutrophil and monocyte counts were higher in SG compared to CG. Thus, recovery of subclinical hematological parameters should be considered in cannabis use disorder patients.
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Affiliation(s)
- Derya Guzel
- Department of Physiology, Medical Faculty, Sakarya University, Sakarya, Turkey
| | - Ahmet Bulent Yazici
- Department of Psychiatry, Sakarya Research & Training Hospital, Sakarya, Turkey
| | - Esra Yazici
- Department of Psychiatry, Medical Faculty, Sakarya University, Sakarya, Turkey
| | - Atila Erol
- Department of Psychiatry, Medical Faculty, Sakarya University, Sakarya, Turkey
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Montagnana M, Danese E. Red cell distribution width and cancer. ANNALS OF TRANSLATIONAL MEDICINE 2016; 4:399. [PMID: 27867951 DOI: 10.21037/atm.2016.10.50] [Citation(s) in RCA: 93] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
Red cell distribution width (RDW) is an index which primarily reflects impaired erythropoiesis and abnormal red blood cell survival. In last years the interest in this marker has considerably grown and now a lot of data are available indicating that this simple and inexpensive parameter is a strong and independent risk factor for death in the general population. Moreover, several investigations have been performed to investigate the role of RDW in cardiovascular and thrombotic disorders. Contrarily, there are relatively few reports focusing on RDW in the area of oncology and to date none review have been performed in this specific field. As such, the aim of this narrative review is to summarize some interesting results obtained in studies performed in patients affected by solid and hematological tumors. Even if larger studies are needed before these preliminary findings can be generalized, it seems plausible to affirm that RDW can be useful by adding prognostic information in patients with oncologic disease.
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Affiliation(s)
- Martina Montagnana
- Clinical Biochemistry Section, University Hospital of Verona, Verona, Italy
| | - Elisa Danese
- Clinical Biochemistry Section, University Hospital of Verona, Verona, Italy
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Yazıcı S, Kırış T, Ceylan US, Akyüz Ş, Uzun AO, Hacı R, Terzi S, Doğan A, Emre A, Yeşilçimen K. The accuracy of combined use of troponin and red cell distribution width in predicting mortality of patients with acute pulmonary embolism. Wien Klin Wochenschr 2016; 128:596-603. [PMID: 27647364 DOI: 10.1007/s00508-016-1081-y] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2016] [Accepted: 08/17/2016] [Indexed: 01/04/2023]
Abstract
BACKGROUND Cardiac troponins and red cell distribution width (RDW) are associated with increased mortality in acute pulmonary embolism (PE). In this study, we aimed to investigate the accuracy of the combined use of troponin and RDW in predicting short-term mortality in acute PE patients. METHODS The data of 201 patients with the diagnosis of acute PE were retrospectively analyzed. We obtained troponin-RDW scores (TR scores) using a combination of troponin and RDW values, and then evaluated this score's accuracy in predicting mortality in patients with acute PE. RESULTS The mean participant age was 68 ± 16 years, and 52 % of patients were female. Fifteen (7.4 %) patients died during the first month. Patients classified as high-risk according to TR scores were older (72 ± 15 vs. 66 ± 15 years, p = 0.005), and they had higher heart rates (101 ± 20 vs. 90 ± 15 beat/min, p < 0.001) and respiratory rates (23 ± 4 vs. 21 ± 3 breath/min, p = 0.001). In multivariate analysis, TR (odds ratio [OR] 4.93, 95 % confidence interval [CI] 1.13-21.38, p = 0.033) and simplified pulmonary embolism severity index (sPESI) scores (OR 3.78, 95 % CI 1.71-8.37, p = 0.002) were independent predictors of 30-day mortality. For 30-day mortality, the TR score had a slightly lower sensitivity (87 % vs. 93 %), but a higher specificity (69 % vs. 52 %) compared to the sPESI score. CONCLUSION The TR score is easy to calculate, and it may be used to predict early mortality in patients with acute PE.
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Affiliation(s)
- Selçuk Yazıcı
- Cardiology Clinic, Dr.Siyami Ersek Thoracic and Cardiovascular Surgery Center, İstanbul, Turkey.
- , Cihadiye Street, No: 61/10 A-Blok, 34840, Altıntepe, Maltepe-İstanbul, Turkey.
| | - Tuncay Kırış
- Atatürk Training and Research Hospital, Cardiology Clinic, Katip Celebi University, İzmir, Turkey
| | - Ufuk S Ceylan
- Cardiology Clinic, Dr.Siyami Ersek Thoracic and Cardiovascular Surgery Center, İstanbul, Turkey
| | - Şükrü Akyüz
- Cardiology Clinic, Dr.Siyami Ersek Thoracic and Cardiovascular Surgery Center, İstanbul, Turkey
| | - Ahmet O Uzun
- Cardiology Clinic, Dr.Siyami Ersek Thoracic and Cardiovascular Surgery Center, İstanbul, Turkey
| | - Recep Hacı
- Cardiology Clinic, Dr.Siyami Ersek Thoracic and Cardiovascular Surgery Center, İstanbul, Turkey
| | - Sait Terzi
- Cardiology Clinic, Dr.Siyami Ersek Thoracic and Cardiovascular Surgery Center, İstanbul, Turkey
| | - Abdullah Doğan
- Medical School, İzmir Katip Celebi University, İzmir, Turkey
| | - Ayşe Emre
- Cardiology Clinic, Dr.Siyami Ersek Thoracic and Cardiovascular Surgery Center, İstanbul, Turkey
| | - Kemal Yeşilçimen
- Cardiology Clinic, Dr.Siyami Ersek Thoracic and Cardiovascular Surgery Center, İstanbul, Turkey
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Uz B. Anisocytosis: A Classical Marker of Inflammation or a New Predictive Marker in Patients with Primary Myelofibrosis. Acta Haematol 2016; 136:191-2. [PMID: 27623285 DOI: 10.1159/000449276] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2016] [Accepted: 08/21/2016] [Indexed: 11/19/2022]
Affiliation(s)
- Burak Uz
- Division of Adult Hematology, Department of Internal Medicine, Faculty of Medicine, Gazi University, Ankara, Turkey
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Sun P, Zhang F, Chen C, Bi X, Yang H, An X, Wang F, Jiang W. The ratio of hemoglobin to red cell distribution width as a novel prognostic parameter in esophageal squamous cell carcinoma: a retrospective study from southern China. Oncotarget 2016; 7:42650-42660. [PMID: 27223088 PMCID: PMC5173164 DOI: 10.18632/oncotarget.9516] [Citation(s) in RCA: 76] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2016] [Accepted: 04/16/2016] [Indexed: 12/17/2022] Open
Abstract
BACKGROUND We propose a novel prognostic parameter for esophageal squamous cell carcinoma (ESCC)-hemoglobin/red cell distribution width (HB/RDW) ratio. Its clinical prognostic value and relationship with other clinicopathological characteristics were investigated in ESCC patients. RESULTS The optimal cut-off value was 0.989 for the HB/RDW ratio. The HB/RDW ratio (P= 0.035), tumor depth (P = 0.020) and lymph node status (P<0.001) were identified to be an independent prognostic factors of OS by multivariate analysis, which was validated by bootstrap resampling. Patients with a low HB/RDW ratio had a 1.416 times greater risk of dying during follow-up compared with those with a high HB/RDW (95% CI = 1.024-1.958, P = 0.035). MATERIALS AND METHODS We retrospectively analyzed 362 patients who underwent curative treatment at a single institution between January 2007 and December 2008. The chi-square test was used to evaluate relationships between the HB/RDW ratio and other clinicopathological variables; the Kaplan-Meier method was used to analyze the 5-year overall survival (OS); and the Cox proportional hazards models were used for univariate and multivariate analyses of variables related to OS. CONCLUSION A significant association was found between the HB/RDW ratio and clinical characteristics and survival outcomes in ESCC patients. Based on these findings, we believe that the HB/RDW ratio is a novel and promising prognostic parameter for ESCC patients.
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Affiliation(s)
- Peng Sun
- State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou, Guangdong Province 510060, P. R. China
- Department of Medical Oncology, Sun Yat-Sen University Cancer Center, Guangzhou, Guangdong Province 510060, P. R. China
| | - Fei Zhang
- State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou, Guangdong Province 510060, P. R. China
- Department of Medical Oncology, Sun Yat-Sen University Cancer Center, Guangzhou, Guangdong Province 510060, P. R. China
| | - Cui Chen
- Department of Oncology, The First Affiliated Hospital, Sun Yat-Sen University, Guangzhou, Guangdong Province 510080, P. R. China
| | - Xiwen Bi
- State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou, Guangdong Province 510060, P. R. China
- Department of Medical Oncology, Sun Yat-Sen University Cancer Center, Guangzhou, Guangdong Province 510060, P. R. China
| | - Hang Yang
- State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou, Guangdong Province 510060, P. R. China
- Department of Medical Oncology, Sun Yat-Sen University Cancer Center, Guangzhou, Guangdong Province 510060, P. R. China
| | - Xin An
- State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou, Guangdong Province 510060, P. R. China
- Department of Medical Oncology, Sun Yat-Sen University Cancer Center, Guangzhou, Guangdong Province 510060, P. R. China
| | - Fenghua Wang
- State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou, Guangdong Province 510060, P. R. China
- Department of Medical Oncology, Sun Yat-Sen University Cancer Center, Guangzhou, Guangdong Province 510060, P. R. China
| | - Wenqi Jiang
- State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou, Guangdong Province 510060, P. R. China
- Department of Medical Oncology, Sun Yat-Sen University Cancer Center, Guangzhou, Guangdong Province 510060, P. R. China
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Evaluation of the effects of red blood cell distribution width on survival in lung cancer patients. Contemp Oncol (Pozn) 2016; 20:153-7. [PMID: 27358595 PMCID: PMC4925737 DOI: 10.5114/wo.2016.60072] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2014] [Accepted: 07/20/2015] [Indexed: 11/17/2022] Open
Abstract
AIM OF THE STUDY Data are available indicating that red blood cell distribution width (RDW) is higher in cancer patients compared to healthy individuals or benign events. In our study, we aimed to investigate the influence of different RDW levels on survival in lung cancer patients. MATERIAL AND METHODS Clinical and laboratory data from 146 patients with lung cancer and 40 healthy subjects were retrospectively studied. RDW was recorded before the application of any treatment. Patients were categorised according to four different RDW cut-off values (median RDW, RDW determined by ROC curve analysis, the upper limit at the automatic blood count device, and RDW cut of value which used in previous studies). Kaplan-Meier survival analysis was used to examine the effect of RDW on survival for each cut-off level. RESULTS The median age of patients was 56.5 years (range: 26-83 years). The difference in median RDW between patients and the control group was statistically significant (14.0 and 13.8, respectively, p = 0.04). There was no difference with regard to overall survival when patients with RDW ≥ 14.0 were compared to those with RDW < 14.0 (p = 0.70); however, overall survival was 3.0 months shorter in low values of its own group in each of the following cut-off values: ≥ 14.2 (p = 0.34), ≥ 14.5 (p = 0.25), ≥ 15 (p = 0.59), although no results were statistically significant. DISCUSSION We consider that the difference between low and high RDW values according to certain cut-off values may reflect the statistics of larger studies although there is a statistically negative correlation between RDW level and survival.
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Podhorecka M, Halicka D, Szymczyk A, Macheta A, Chocholska S, Hus M, Darzynkiewicz Z. Assessment of red blood cell distribution width as a prognostic marker in chronic lymphocytic leukemia. Oncotarget 2016; 7:32846-53. [PMID: 27147570 PMCID: PMC5078056 DOI: 10.18632/oncotarget.9055] [Citation(s) in RCA: 40] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2016] [Accepted: 04/08/2016] [Indexed: 01/25/2023] Open
Abstract
Red blood cell distribution width (RDW) is a quantitative measure of the variability in size of circulating erythrocytes. It was recently reported that RDW is a prognostic factor for infection diseases, cardiovascular and pulmonary diseases, as well as some neoplasms. Moreover, RDW is remarkably strong predictor of longevity, including all causes of death, for adults aged 45 years and older. To explain this occurrence it was proposed that persistent IGFs/mTOR signaling is one of the factors that play a role in affecting the RDW and mortality.The above observations induced us to analyze the prognostic role of RDW in chronic lymphocytic leukemia (CLL) being the most frequent type of adult leukemia in Western countries. The obtained results have shown that RDW may be considered as a potential CLL prognostic marker. Elevated RDW level at the moment of diagnosis was associated with advanced disease and presence of other poor prognostic factors. It is also connected with overall survival indicating shorter time in patients with elevated RDW. It is possible that the presently observed correlation between mortality and RDW of the CLL patients is affected by their metabolic (IGF-1/mTOR driven)- rather than chronological- aging. The patients with high level of RDW are expected to have an increased persistent level of IGF-1/mTOR signaling. Within the framework of personalized therapy, these CLL patients therefore would be expected to be more sensitive to the treatment with mTOR inhibitors.
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MESH Headings
- Adult
- Aged
- Aged, 80 and over
- Antineoplastic Agents/therapeutic use
- Erythrocyte Indices
- Erythrocytes/metabolism
- Female
- Humans
- Insulin-Like Growth Factor I/metabolism
- Kaplan-Meier Estimate
- Leukemia, Lymphocytic, Chronic, B-Cell/blood
- Leukemia, Lymphocytic, Chronic, B-Cell/diagnosis
- Leukemia, Lymphocytic, Chronic, B-Cell/drug therapy
- Leukemia, Lymphocytic, Chronic, B-Cell/mortality
- Male
- Middle Aged
- Molecular Targeted Therapy
- Predictive Value of Tests
- Prognosis
- Proportional Hazards Models
- Protein Kinase Inhibitors/therapeutic use
- Retrospective Studies
- Risk Factors
- Signal Transduction
- TOR Serine-Threonine Kinases/antagonists & inhibitors
- TOR Serine-Threonine Kinases/blood
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Affiliation(s)
- Monika Podhorecka
- Department of Hematooncology and Bone Marrow Transplantation, Medical University of Lublin, Lublin, Poland
| | - Dorota Halicka
- Department of Pathology, New York Medical College, Valhalla, New York, USA
| | - Agnieszka Szymczyk
- Department of Hematooncology and Bone Marrow Transplantation, Medical University of Lublin, Lublin, Poland
| | - Arkadiusz Macheta
- Department of Hematooncology and Bone Marrow Transplantation, Medical University of Lublin, Lublin, Poland
| | - Sylwia Chocholska
- Department of Hematooncology and Bone Marrow Transplantation, Medical University of Lublin, Lublin, Poland
| | - Marek Hus
- Department of Hematooncology and Bone Marrow Transplantation, Medical University of Lublin, Lublin, Poland
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Periša V, Zibar L, Sinčić-Petričević J, Knezović A, Periša I, Barbić 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 2016; 56:334-43. [PMID: 26321026 PMCID: PMC4576747 DOI: 10.3325/cmj.2015.56.334] [Citation(s) in RCA: 49] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
Aim To determine the prognostic value of baseline red blood cell distribution width (RDW) in diffuse large B cell lymphoma (DLBCL) patients. Methods Data from 81 DLBCL patients diagnosed from 2006 to 2013 at the University Hospital Center Osijek, Osijek, Croatia, were reviewed. We evaluated disease outcome, overall survival (OS) and event-free survival (EFS), and demographic, clinical and laboratory factors affecting outcome. Univariate analysis and Cox regression analysis were used. Results Median age of patients was 64 years, 29 were men (35.8%). Higher RDW levels (%) were found in patients with advanced Ann Arbor clinical stage (14.94 ± 1.82 vs 13.55 ± 1.54, P = 0.001) and in those with poor response to therapy (14.94 ± 1.82 vs 13.55 ± 1.54, P = 0.001). Patients with RDW>15% (cut-off was calculated by receiver operating characteristics) had significantly worse OS (median [range], 33 months [20-46] vs 74 months [65-82], P < 0.001) and EFS (27 months [15-40] vs 68 months [59-77], P < 0.001). Cox regression analysis showed that RDW>15% was an independent prognostic factor for OS (HR 3.654, 95% CI 1.128-11.836) and EFS (HR 2.611, 95% CI 1.012-6-739). Conclusion High baseline RDW is an independent prognostic marker of poor outcome in patients with DLBCL. RDW could be an easily available and inexpensive marker for the risk stratification in patients with DLBCL.
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Affiliation(s)
- Vlatka Periša
- Vlatka Periša, Department of Hematology, Clinic of Internal Medicine, University Hospital Centre Osijek, Huttlerova 4, 31000 Osijek, Croatia,
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Dagistan Y, Dagistan E, Citisli V. Evaluation of simple blood counts as inflammation markers for brain tumor patients. Neurol Neurochir Pol 2016; 50:231-5. [PMID: 27375135 DOI: 10.1016/j.pjnns.2016.03.002] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2015] [Revised: 01/26/2016] [Accepted: 03/07/2016] [Indexed: 10/22/2022]
Abstract
AIMS Hemogram parameters in routine blood panels have been proposed as inflammation markers. These parameters, especially the red cell distribution width (RDW) and mean platelet volume (MPV), were evaluated as surrogate inflammatory markers in brain tumor patients. We aimed to observe RDW and MPV values of tumor patients and compare to those in healthy population. METHODS We recorded white blood cell count, neutrophil count, lymphocyte count, hemoglobin, hematocrit, RDW, platelet count, and MPV of the study group at the time of diagnosis and compared to those of the control subjects. RESULTS The RDW was significantly elevated in study group compared to that of the control subjects (p=0.001). The MPV was significantly lower in study group than that of the control group (p=0.01). CONCLUSION Decreased MPV and increased RDW were both associated with brain tumor. However, prospective studies with larger sample sizes are needed to support the results and expose MPV and RDW variations between metastatic and primary brain tumors.
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Affiliation(s)
- Yasar Dagistan
- Abant Izzet Baysal University Hospital, Department of Neurosurgery, Bolu, Turkey.
| | - Emine Dagistan
- Abant Izzet Baysal University Hospital, Department of Radiology, Bolu, Turkey
| | - Veli Citisli
- Pamukkale University Hospital, Department of Neurosurgery, Denizli, Turkey
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Wan GX, Chen P, Cai XJ, Li LJ, Yu XJ, Pan DF, Wang XH, Wang XB, Cao FJ. Elevated red cell distribution width contributes to a poor prognosis in patients with esophageal carcinoma. Clin Chim Acta 2015; 452:199-203. [PMID: 26633854 DOI: 10.1016/j.cca.2015.11.025] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2015] [Revised: 11/24/2015] [Accepted: 11/24/2015] [Indexed: 12/28/2022]
Abstract
BACKGROUND The red cell distribution width (RDW) has also been reported to reliably reflect the inflammation and nutrition status and predict the prognosis across several types of cancer, however, the prognostic value of RDW in esophageal carcinoma has seldom been studied. METHODS A retrospective study was performed to assess the prognostic value of RDW in patients with esophageal carcinoma by the Kaplan-Meier analysis and multivariate Cox regression proportional hazard model. All enrolled patients were divided into high RDW group (≧15%) and low RDW group (<15%) according to the detected RDW values. RESULTS Clinical and laboratory data from a total of 179 patients with esophageal carcinoma were retrieved. With a median follow-up of 21months, the high RDW group exhibited a shorter disease-free survival (DFS) (p<0.001) and an unfavorable overall survival (OS) (p<0.001) in the univariate analysis. The multivariate analysis revealed that elevated RDW at diagnosis was an independent prognostic factor for shorter PFS (p=0.043, HR=1.907, 95% CI=1.020-3.565) and poor OS (p=0.042, HR=1.895, 95% CI=1.023-3.508) after adjustment with other cancer-related prognostic factors. CONCLUSION The present study suggests that elevated preoperative RDW(≧15%) at the diagnosis may independently predict poorer disease-free and overall survival among patients with esophageal carcinoma.
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Affiliation(s)
- Guo-Xing Wan
- Department of Oncology, Renmin Hospital, Hubei University of Medicine, Shiyan 442000, Hubei, China
| | - Ping Chen
- Department of Oncology, Renmin Hospital, Hubei University of Medicine, Shiyan 442000, Hubei, China
| | - Xiao-Jun Cai
- Department of Oncology, Renmin Hospital, Hubei University of Medicine, Shiyan 442000, Hubei, China
| | - Lin-Jun Li
- Department of Oncology, Renmin Hospital, Hubei University of Medicine, Shiyan 442000, Hubei, China
| | - Xiong-Jie Yu
- Department of Oncology, Renmin Hospital, Hubei University of Medicine, Shiyan 442000, Hubei, China
| | - Dong-Feng Pan
- Department of Oncology, Renmin Hospital, Hubei University of Medicine, Shiyan 442000, Hubei, China
| | - Xian-He Wang
- Department of Oncology, Renmin Hospital, Hubei University of Medicine, Shiyan 442000, Hubei, China
| | - Xuan-Bin Wang
- Department of Oncology, Renmin Hospital, Hubei University of Medicine, Shiyan 442000, Hubei, China
| | - Feng-Jun Cao
- Department of Oncology, Renmin Hospital, Hubei University of Medicine, Shiyan 442000, Hubei, China.
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Ellingsen TS, Lappegård J, Skjelbakken T, Braekkan SK, Hansen JB. Impact of red cell distribution width on future risk of cancer and all-cause mortality among cancer patients - the Tromsø Study. Haematologica 2015; 100:e387-9. [PMID: 26113420 DOI: 10.3324/haematol.2015.129601] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Affiliation(s)
- Trygve S Ellingsen
- K.G. Jebsen Thrombosis Research and Expertise Center, Department of Clinical Medicine, University of Tromsø, Tromsø, Norway Hematological Research Group, Department of Clinical Medicine, University of Tromsø, Tromsø, Norway
| | - Jostein Lappegård
- K.G. Jebsen Thrombosis Research and Expertise Center, Department of Clinical Medicine, University of Tromsø, Tromsø, Norway Hematological Research Group, Department of Clinical Medicine, University of Tromsø, Tromsø, Norway
| | - Tove Skjelbakken
- K.G. Jebsen Thrombosis Research and Expertise Center, Department of Clinical Medicine, University of Tromsø, Tromsø, Norway Hematological Research Group, Department of Clinical Medicine, University of Tromsø, Tromsø, Norway Division of Internal Medicine, University Hospital of North Norway, Tromsø, Norway
| | - Sigrid K Braekkan
- K.G. Jebsen Thrombosis Research and Expertise Center, Department of Clinical Medicine, University of Tromsø, Tromsø, Norway Hematological Research Group, Department of Clinical Medicine, University of Tromsø, Tromsø, Norway Division of Internal Medicine, University Hospital of North Norway, Tromsø, Norway
| | - John-Bjarne Hansen
- K.G. Jebsen Thrombosis Research and Expertise Center, Department of Clinical Medicine, University of Tromsø, Tromsø, Norway Hematological Research Group, Department of Clinical Medicine, University of Tromsø, Tromsø, Norway Division of Internal Medicine, University Hospital of North Norway, Tromsø, Norway
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