Prognostic value of red cell volume distribution width in hematological malignancies: a meta-analysis_West China Medical Journal

Authors：

JIANG Peizhen ¹ , WANG Wenru ¹ , LI Rui ² ,  TANG Xudong ¹

1. Department of Hematology, Xiyuan Hospital, China Academy of Chinese Medical Sciences, Beijing 100091, P. R. China;
2. Clinical School of Medicine, Beijing University of Chinese Medicine, Beijing 100029, P. R. China;

Corresponding author：

TANG Xudong, Email: tangxudong001@163.com

Keywords：

Red cell volume distribution width; myelodysplastic syndrome; leukemia; hematological malignancy; meta-analysis

DOI：

10.7507/1002-0179.202110094

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Objective To explore the prognostic value of red cell volume distribution width (RDW) for hematological malignancies. Methods PubMed, Embase, Web of Science, Cochrane Library, China National Knowledge Infrastructure, Wanfang, Chongqing VIP, and SinoMed were searched for related literatures on myelodysplastic syndrome, leukemia and other hematological malignancies and pretreatment RDW from the establishment of databases to April 5, 2022. The main statistical indicators were Hazard ratio (HR) and its 95% confidence interval (CI). Stata 12.0 SE software was used for analysis, and Q test was used to evaluate literature heterogeneity. Subgroup pooled analysis was used to evaluate the prognostic value of RDW. Results A total of 7 articles were included, with a total of 804 patients. A fixed-effect model was selected for meta-analysis, and the results showed that patients with elevated pretreatment RDW had worse overall survival [HR=2.91, 95%CI (2.01, 4.22), I²=0%, P=0.714]. The results of subgroup analysis for different types of diseases showed that in myelodysplastic syndrome group [HR=2.61, 95%CI (1.28, 5.31), I²=22.0%, P=0.258)], chronic myeloid leukemia group [HR= 3.24, 95%CI (1.91, 5.51), I²=0%, P=0.546], and adult T-cell leukemia/lymphoma group [HR=2.64, 95%CI (1.22, 5.70)], the overall survival rate of patients with elevated pretreatment RDW were worse. Sensitivity analysis showed that the study was stable and there was no heterogeneity in the overall study result.Conclusion Elevated pretreatment RDW is associated with overall survival and can be used as an indicator for evaluating the prognosis of hematological malignancies, but large sample studies are still needed to determine the best predictive cutoff for various diseases.

Citation： JIANG Peizhen, WANG Wenru, LI Rui, TANG Xudong. Prognostic value of red cell volume distribution width in hematological malignancies: a meta-analysis. West China Medical Journal, 2022, 37(6): 885-892. doi: 10.7507/1002-0179.202110094 Copy

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2.	De Kouchkovsky I, Abdul-Hay M. Acute myeloid leukemia: a comprehensive review and 2016 update. Blood Cancer J, 2016, 6(7): e441.
3.	Lippi G, Turcato G, Cervellin G, et al. Red blood cell distribution width in heart failure: A narrative review. World J Cardiol, 2018, 10(2): 6-14.
4.	Siegler JE, Marcaccio C, Nawalinski K, et al. Elevated red cell distribution width is associated with cerebral infarction in aneurysmal subarachnoid hemorrhage. Neurocrit Care, 2017, 26(1): 26-33.
5.	Hammons L, Filopei J, Steiger D, et al. A narrative review of red blood cell distribution width as a marker for pulmonary embolism. J Thromb Thrombolysis, 2019, 48(4): 638-647.
6.	Li J, Yang X, Ma J, et al. Relationship of red blood cell distribution width with cancer mortality in hospital. Biomed Res Int, 2018, 2018: 8914617.
7.	Henry BM, Benoit JL, Benoit S, et al. Red blood cell distribution width (RDW) predicts COVID-19 severity: a prospective, observational study from the Cincinnati SARS-CoV-2 emergency department cohort. Diagnostics (Basel), 2020, 10(9): 618.
8.	Maia C, Puig N, Cedena MT, et al. Biological and clinical significance of dysplastic hematopoiesis in patients with newly diagnosed multiple myeloma. Blood, 2020, 135(26): 2375-2387.
9.	Stang A. Critical evaluation of the Newcastle-Ottawa scale for the assessment of the quality of nonrandomized studies in meta-analyses. Eur J Epidemiol, 2010, 25(9): 603-605.
10.	Tierney JF, Stewart LA, Ghersi D, et al. Practical methods for incorporating summary time-to-event data into meta-analysis. Trials, 2007, 8: 16.
11.	Turgutkaya A, Akın N, Sargın G, et al. The relationship between red cell distribution width and prognostic scores in myelodysplastic syndrome. Hematol Transfus Cell Ther, 2021, 29: S2531-1379(21)00001-8.
12.	Mao XL, Xi YM, Li ZJ, et al. Higher red blood cell distribution width at diagnose is a simple negative prognostic factor in chronic phase-chronic myeloid leukemia patients treated with tyrosine kinase inhibitors: a retrospective study. Medicine (Baltimore), 2021, 100(10): e24003.
13.	Li T, Li X, Chen H, et al. Higher red blood cell distribution width is a poor prognostic factor for patients with chronic myeloid leukemia. Cancer Manag Res, 2021, 13: 1233-1243.
14.	范丹丹. 红细胞分布宽度(RDW)对慢性髓系白血病慢性期(CML-CP)诊疗及预后评估的价值研究. 百色: 右江民族医学院, 2020.
15.	Obama K, Tabuchi T, Inoue H. Prognostic impact of red cell distribution width in adult T-cell leukemia/lymphoma. Leuk Res, 2020, 99: 106474.
16.	Shi Z, Li B, Huang H, et al. Prognostic impact of red blood cell distribution width in myelodysplastic syndromes. Br J Haematol, 2019, 186(2): 352-355.
17.	Iriyama N, Hatta Y, Kobayashi S, et al. Higher red blood cell distribution width is an adverse prognostic factor in chronic-phase chronic myeloid leukemia patients treated with tyrosine kinase inhibitors. Anticancer Res, 2015, 35(10): 5473-5478.
18.	Su C, Liao LZ, Song Y, et al. The role of red blood cell distribution width in mortality and cardiovascular risk among patients with coronary artery diseases: a systematic review and meta-analysis. J Thorac Dis, 2014, 6(10): 1429-1440.
19.	Li B, You Z, Xiong XZ, et al. Elevated red blood cell distribution width predicts poor prognosis in hilar cholangiocarcinoma. Oncotarget, 2017, 8(65): 109468-109477.
20.	Hu L, Li M, Ding Y, et al. Prognostic value of RDW in cancers: a systematic review and meta-analysis. Oncotarget, 2017, 8(9): 16027-16035.
21.	Han F, Liu Y, Cheng S, et al. Diagnosis and survival values of neutrophil-lymphocyte ratio (NLR) and red blood cell distribution width (RDW) in esophageal cancer. Clin Chim Acta, 2019, 488: 150-158.
22.	Ustaoglu M, Aktas G, Avcioglu U, et al. Elevated platelet distribution width and red cell distribution width are associated with autoimmune liver diseases. Eur J Gastroenterol Hepatol, 2021, 33(Suppl 1): e905-e908.
23.	Salvagno GL, Sanchis-Gomar F, Picanza A, et al. Red blood cell distribution width: a simple parameter with multiple clinical applications. Crit Rev Clin Lab Sci, 2015, 52(2): 86-105.
24.	Taneri PE, Gómez-Ochoa SA, Llanaj E, et al. Anemia and iron metabolism in COVID-19: a systematic review and meta-analysis. Eur J Epidemiol, 2020, 35(8): 763-773.
25.	Baba Y, Saito B, Shimada S, et al. Association of red cell distribution width with clinical outcomes in myelodysplastic syndrome. Leuk Res, 2018, 67: 56-59.
26.	Abelson S, Collord G, Ng SWK, et al. Prediction of acute myeloid leukaemia risk in healthy individuals. Nature, 2018, 559(7714): 400-404.
27.	Muto Y, Nishiyama M, Nita A, et al. Essential role of FBXL5-mediated cellular iron homeostasis in maintenance of hematopoietic stem cells. Nat Commun, 2017, 8: 16114.
28.	Bulycheva E, Rauner M, Medyouf H, et al. Myelodysplasia is in the niche: novel concepts and emerging therapies. Leukemia, 2015, 29(2): 259-268.
29.	毛夏丽. RDW 评估 TKI 治疗初诊慢性粒细胞白血病疗效及预后的价值. 兰州: 兰州大学, 2020.
30.	Bento L, Díaz-López A, Barranco G, et al. New prognosis score including absolute lymphocyte/monocyte ratio, red blood cell distribution width and beta-2 microglobulin in patients with diffuse large B-cell lymphoma treated with R-CHOP: Spanish lymphoma group experience (GELTAMO). Br J Haematol, 2020, 188(6): 888-897.
31.	蒋小燕. 探讨红细胞分布宽度在多发性骨髓瘤预后及化疗方案选择中的价值. 南昌: 南昌大学, 2019.
32.	孙超, 叶鉴南, 王欢, 等. 红细胞分布宽度在老年非移植多发性骨髓瘤患者中的预后价值探讨. 中国实验血液学杂志, 2019, 27(1): 115-122.

1. Montalban-Bravo G, Garcia-Manero G. Myelodysplastic syndromes: 2018 update on diagnosis, risk-stratification and management. Am J Hematol, 2018, 93(1): 129-147.
2. De Kouchkovsky I, Abdul-Hay M. Acute myeloid leukemia: a comprehensive review and 2016 update. Blood Cancer J, 2016, 6(7): e441.
3. Lippi G, Turcato G, Cervellin G, et al. Red blood cell distribution width in heart failure: A narrative review. World J Cardiol, 2018, 10(2): 6-14.
4. Siegler JE, Marcaccio C, Nawalinski K, et al. Elevated red cell distribution width is associated with cerebral infarction in aneurysmal subarachnoid hemorrhage. Neurocrit Care, 2017, 26(1): 26-33.
5. Hammons L, Filopei J, Steiger D, et al. A narrative review of red blood cell distribution width as a marker for pulmonary embolism. J Thromb Thrombolysis, 2019, 48(4): 638-647.
6. Li J, Yang X, Ma J, et al. Relationship of red blood cell distribution width with cancer mortality in hospital. Biomed Res Int, 2018, 2018: 8914617.
7. Henry BM, Benoit JL, Benoit S, et al. Red blood cell distribution width (RDW) predicts COVID-19 severity: a prospective, observational study from the Cincinnati SARS-CoV-2 emergency department cohort. Diagnostics (Basel), 2020, 10(9): 618.
8. Maia C, Puig N, Cedena MT, et al. Biological and clinical significance of dysplastic hematopoiesis in patients with newly diagnosed multiple myeloma. Blood, 2020, 135(26): 2375-2387.
9. Stang A. Critical evaluation of the Newcastle-Ottawa scale for the assessment of the quality of nonrandomized studies in meta-analyses. Eur J Epidemiol, 2010, 25(9): 603-605.
10. Tierney JF, Stewart LA, Ghersi D, et al. Practical methods for incorporating summary time-to-event data into meta-analysis. Trials, 2007, 8: 16.
11. Turgutkaya A, Akın N, Sargın G, et al. The relationship between red cell distribution width and prognostic scores in myelodysplastic syndrome. Hematol Transfus Cell Ther, 2021, 29: S2531-1379(21)00001-8.
12. Mao XL, Xi YM, Li ZJ, et al. Higher red blood cell distribution width at diagnose is a simple negative prognostic factor in chronic phase-chronic myeloid leukemia patients treated with tyrosine kinase inhibitors: a retrospective study. Medicine (Baltimore), 2021, 100(10): e24003.
13. Li T, Li X, Chen H, et al. Higher red blood cell distribution width is a poor prognostic factor for patients with chronic myeloid leukemia. Cancer Manag Res, 2021, 13: 1233-1243.
14. 范丹丹. 红细胞分布宽度(RDW)对慢性髓系白血病慢性期(CML-CP)诊疗及预后评估的价值研究. 百色: 右江民族医学院, 2020.
15. Obama K, Tabuchi T, Inoue H. Prognostic impact of red cell distribution width in adult T-cell leukemia/lymphoma. Leuk Res, 2020, 99: 106474.
16. Shi Z, Li B, Huang H, et al. Prognostic impact of red blood cell distribution width in myelodysplastic syndromes. Br J Haematol, 2019, 186(2): 352-355.
17. Iriyama N, Hatta Y, Kobayashi S, et al. Higher red blood cell distribution width is an adverse prognostic factor in chronic-phase chronic myeloid leukemia patients treated with tyrosine kinase inhibitors. Anticancer Res, 2015, 35(10): 5473-5478.
18. Su C, Liao LZ, Song Y, et al. The role of red blood cell distribution width in mortality and cardiovascular risk among patients with coronary artery diseases: a systematic review and meta-analysis. J Thorac Dis, 2014, 6(10): 1429-1440.
19. Li B, You Z, Xiong XZ, et al. Elevated red blood cell distribution width predicts poor prognosis in hilar cholangiocarcinoma. Oncotarget, 2017, 8(65): 109468-109477.
20. Hu L, Li M, Ding Y, et al. Prognostic value of RDW in cancers: a systematic review and meta-analysis. Oncotarget, 2017, 8(9): 16027-16035.
21. Han F, Liu Y, Cheng S, et al. Diagnosis and survival values of neutrophil-lymphocyte ratio (NLR) and red blood cell distribution width (RDW) in esophageal cancer. Clin Chim Acta, 2019, 488: 150-158.
22. Ustaoglu M, Aktas G, Avcioglu U, et al. Elevated platelet distribution width and red cell distribution width are associated with autoimmune liver diseases. Eur J Gastroenterol Hepatol, 2021, 33(Suppl 1): e905-e908.
23. Salvagno GL, Sanchis-Gomar F, Picanza A, et al. Red blood cell distribution width: a simple parameter with multiple clinical applications. Crit Rev Clin Lab Sci, 2015, 52(2): 86-105.
24. Taneri PE, Gómez-Ochoa SA, Llanaj E, et al. Anemia and iron metabolism in COVID-19: a systematic review and meta-analysis. Eur J Epidemiol, 2020, 35(8): 763-773.
25. Baba Y, Saito B, Shimada S, et al. Association of red cell distribution width with clinical outcomes in myelodysplastic syndrome. Leuk Res, 2018, 67: 56-59.
26. Abelson S, Collord G, Ng SWK, et al. Prediction of acute myeloid leukaemia risk in healthy individuals. Nature, 2018, 559(7714): 400-404.
27. Muto Y, Nishiyama M, Nita A, et al. Essential role of FBXL5-mediated cellular iron homeostasis in maintenance of hematopoietic stem cells. Nat Commun, 2017, 8: 16114.
28. Bulycheva E, Rauner M, Medyouf H, et al. Myelodysplasia is in the niche: novel concepts and emerging therapies. Leukemia, 2015, 29(2): 259-268.
29. 毛夏丽. RDW 评估 TKI 治疗初诊慢性粒细胞白血病疗效及预后的价值. 兰州: 兰州大学, 2020.
30. Bento L, Díaz-López A, Barranco G, et al. New prognosis score including absolute lymphocyte/monocyte ratio, red blood cell distribution width and beta-2 microglobulin in patients with diffuse large B-cell lymphoma treated with R-CHOP: Spanish lymphoma group experience (GELTAMO). Br J Haematol, 2020, 188(6): 888-897.
31. 蒋小燕. 探讨红细胞分布宽度在多发性骨髓瘤预后及化疗方案选择中的价值. 南昌: 南昌大学, 2019.
32. 孙超, 叶鉴南, 王欢, 等. 红细胞分布宽度在老年非移植多发性骨髓瘤患者中的预后价值探讨. 中国实验血液学杂志, 2019, 27(1): 115-122.

West China Medical Journal

Prognostic value of red cell volume distribution width in hematological malignancies: a meta-analysis

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