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Higher Red Blood Cell Distribution Width is a Poor Prognostic Factor for Patients with Chronic Myeloid Leukemia

Authors Li T, Li X, Chen H, Huang KZ, Xie Q, Ge HY, Gao SM, Feng JH, Yang JJ, Chen ZG, Zheng XQ

Received 18 November 2020

Accepted for publication 25 January 2021

Published 10 February 2021 Volume 2021:13 Pages 1233—1243

DOI https://doi.org/10.2147/CMAR.S288589

Checked for plagiarism Yes

Review by Single anonymous peer review

Peer reviewer comments 4

Editor who approved publication: Professor Bilikere Dwarakanath


Tao Li,1,2 Xin Li,1 Hui Chen,3 Kai-Zhao Huang,1 Qi Xie,1,2 Han-Yu Ge,1 Shen-Meng Gao,4 Jian-Hua Feng,4 Jun-Jun Yang,1 Zhan-Guo Chen,1 Xiao-Qun Zheng1,2

1Department of Laboratory Medicine, The Second Affiliated Hospital and Yuying Children’s Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, People’s Republic of China; 2School of Laboratory Medicine and Life Sciences, Wenzhou Medical University, The Key Laboratory of Laboratory Medicine, Ministry of Education of China, Wenzhou, Zhejiang, People’s Republic of China; 3Department of Emergency, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, People’s Republic of China; 4Department of Hematology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, People’s Republic of China

Correspondence: Zhan-Guo Chen; Xiao-Qun Zheng
Department of Laboratory Medicine, The Second Affiliated Hospital and Yuying Children’s Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, People’s Republic of China
Tel +86-13968806755
; +86-13906653839
Email steve0577@126.com; jszhengxq@163.com

Purpose: Red blood cell distribution width (RDW) has been considered as a potential indicator of the effects of treatment or as a prognostic indicator for various malignancies. Most chronic myeloid leukemia (CML) patients are in the chronic phase, but some have transformed to accelerated phase or blast phase (blast crisis). However, the clinical significance of RDW in CML remains limited.
Patients and Methods: In the present study, detailed clinical information and the RDW of 168 healthy people and 153 CML patients (106 patients for the training cohort and 47 patients for the validation cohort) were retrospectively assessed.
Results: Multivariate analysis demonstrated that patient age (OR, 1.081; 95CI% 1.039∼ 1.125; p < 0.001), platelet counts (OR, 0.997; 95CI% 0.994∼ 0.999; p = 0.001) and RDW at admission (OR,1.469; 95CI% 1.121∼ 1.925; p = 0.005) were significantly associated with the patients with advanced phase. Among CML patients in the chronic phase, higher RDW was significantly associated with overall survival (OS; p = 0.0008) and the event-free survival (EFS; p = 0.0221) among CML patients with chronic phase, but not with Transformation-free survival (TFS; p = 0.0821). Furthermore, higher RDW was associated with higher mortality compared to patients with low RDW (CML-associated deaths; p < 0.0001). In addition, a decline in RDW is associated with the treatment of CML patients with tyrosine kinase inhibitors, especially at 6 and 12 months after the start of treatment.
Conclusion: Higher RDW is a potential prognostic biomarker for chronic CML patients.

Keywords: red blood cell distribution width, chronic myeloid leukemia, chronic phase, adverse prognosis

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