Journal of Molecular Biomarkers and Clinical Trials

RDW is a Novel Prognostic Parameter in Diffuse Large B Cell Lymphoma in the Rituximab Era

*Fatih Teker
Medical Oncology Department, Diyarbakir Training And Research Hospital, Turkey

*Corresponding Author:
Fatih Teker
Medical Oncology Department, Diyarbakir Training And Research Hospital, Turkey
Email:fthtkr@gmail.com

Published on: 2017-01-29

Abstract

After the invention of rituximab, RCHOP became the standard regimen for Diffuse Large B cell lymphomas (DLBCL). Some patients still have a poor prognosis. Recent researches on Non-Hodgkin lymphoma has been related with prognostic biomarkers. Elevated RDW is accepted as a worse prognostic factor in some situations and diseases but the prognostic value has not been studied in DLBCL. The aim of this study was to investigate the prognostic role of RDW in DLBCL. Clinical and laboratory data from 217 DLBCL patients were retrospectively studied in a single center by multivariate analysis, Kaplan-Meier survival analysis, forward stepwise and Cox regression analysis were used to examine the effect of RDW on survival. In this data set, elevated RDW levels were strongly associated with shorter survival. RDW was determined as a predictor of mortality and seems to be a simple, cost-effective novel prognostic parameter in DLBCL in the rituximab era.

Keywords

Erythrocytes; Chemotherapy; Lymphoma; RDW; Prognostic; Biomarker

Introduction

Diffuse Large B-cell lymphoma (DLBCL) is the most common form of non-Hodgkin’s lymphoma. Although the addition of rituximab has improved survival, some patients are still refractory to standard therapy. To better identify patients at high risk for poor prognosis, a number of conventional parameters have been defined. The age of patient, gender, clinical stage, beta-2 microglobulin level, serum albumin level, IPI score, LDH, are well known factors. Several ongoing studies are evaluating the prognostic role of new parameters in DLBCL such as CRP, neutrophil to lymphocyte ratio (NLR), lymphocyte to monocyte ratio (LMR), absolute lymphocyte count (ALC) and Ki-67. These novel parameters have been defined recently for predicting the response to therapy and survival. Recent studies have shown that red cell distribution width (RDW) has been reported as a prognostic marker in various situations such as cardiovascular diseases, kidney diseases, critically ill patients and some cancers such as lung cancer, breast cancer and multiple myeloma. On the other hand the importance of RDW is lacking in DLBCL. The aim of this study was to determine the association between RDW and survival in DLBCL.