Red Blood Cell Distribution Width As A Prognostic Factor In Diffuse Large B-cell Patients:A Single Center’s Results Of Retrospective Analysis

Objective: This study aimed to test and verify the prognostic value of red blood cell distribution width(RDW)in diffuse large B cell lymphoma(DLBCL)patients.Methods: The relationship between RDW and other clinical characteristics(including prognosis)was studied in 122 DLBCL patients from Jan 2010 to June 2017 in our center.The log-rank test,Kaplan-Meier method and ROC curve,ANOVA,paired t test and correlation analysis were used as appropriate.Result: A RDW of 14.6%was considered to be the optimal cut-off value according to ROC analysis.We classified all patients into two groups according to the cut-off value.We observed that there was a significant positive correlation between RDW and extra-nodal sites of disease,ECOG PS,CRP,AST,ALT,Ann-Arbor stage,IPI and NCCN-IPI.A negative correlation between RDW and RBC,hemoglobin,albumin,orthochromatic erythroblast was confirmed in the meanwhile.We found OS and PFS were not statistically different between normal or and elevated RDW group(cut-off value:14.6%).The same result was obtained when it came to subgroup analysis according to treatment regimen groups(mainly CHOP,mainly R-CHOP,CHOP/R-CHOP mixed).The only statistically different parameter was EFS and elevated RDW indicated shorter EFS(25.4vs39.9months).In the same way,after classifying patients into two groups according to the proportion of orthochromatic erythroblast in bone marrow examination(cut-off value: 11%),OS\EFS\PFS were significantly different between two groups(OS: 58.8vs45.0;EFS: 42.3vs25.0;PFS: 47.8vs35.1,months).Patients with the proportion of orthochromatic erythroblast >=11% had a better prognosis.Conclusion: We concluded that RDW may not be a reliable parameter to do DLBCL risk stratification and survival prediction.We found that a lower proportion at diagnosis indicated a worse prognosis.So the proportion of orthochromatic erythroblasts in bone marrow could be a prognostic factor that can be used to the stratification of DLBCL patients.