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Red blood cell distribution width and platelet counts are independent prognostic factors and improve the predictive ability of IPI score in diffuse large B-cell lymphoma patients

Authors
  • Li, Manman1, 2
  • Xia, Hailong3
  • Zheng, Huimin1, 2
  • Li, Yafeng4
  • Liu, Jun1, 2
  • Hu, Linhui1, 2
  • Li, Jingrong5
  • Ding, Yangyang1, 2
  • Pu, Lianfang6
  • Gui, Qianle1, 2
  • Zheng, Yijie7
  • Zhai, Zhimin1, 2
  • Xiong, Shudao1, 2
  • 1 The Second Hospital of Anhui Medical University, Department of Hematology/Hematological Lab, Hefei, Anhui Province, 230601, People’s Republic of China , Hefei (China)
  • 2 Anhui Medical University, Hematology Research Center, Hefei, 230601, People’s Republic of China , Hefei (China)
  • 3 Chaohu Hospital of Anhui Medical University, Department of Hematology, Chaohu, 238000, People’s Republic of China , Chaohu (China)
  • 4 The First Hospital of Anhui Medical University, Department of Hematology, Hefei, 230000, People’s Republic of China , Hefei (China)
  • 5 The Second Hospital of Anhui Medical university, Department of Emergency, Hefei, Anhui Province, 230601, People’s Republic of China , Hefei (China)
  • 6 The Third People’s Hospital of Bengbu, Department of Hematology, Bengbu, 233000, People’s Republic of China , Bengbu (China)
  • 7 Fudan University, Department of Immunology and Key Laboratory of Molecular Medicine of Ministry Education, Shanghai Medical College, Shanghai, 200032, People’s Republic of China , Shanghai (China)
Type
Published Article
Journal
BMC Cancer
Publisher
Springer (Biomed Central Ltd.)
Publication Date
Nov 11, 2019
Volume
19
Issue
1
Identifiers
DOI: 10.1186/s12885-019-6281-1
Source
Springer Nature
Keywords
License
Green

Abstract

BackgroundElevated red blood cell distribution width (RDW) and decreased platelet count (PLT) can be clinically relevant to the prognosis in cancer patients. However, their prognostic values in patients with diffuse large B-cell lymphoma (DLBCL) need to be further explored.MethodsHealthy donors (n = 130) and patients with DLBCL (n = 349) were included and evaluated retrospectively in this study. The prognostic influence of clinical and pathological factors including RDW and PLT on overall survival (OS) and progression-free survival (PFS) were studied by Kaplan-Meier curves. To evaluate the independent prognostic relevance of RDW and PLT, univariate and multivariate Cox proportional hazards regression models were applied. The adjusted IPI model was established based on the results of multivariate analysis, and verified by Harrell’s C statistical analysis.ResultsKaplan-Meier curves indicated that an elevated RDW value and thrombocytopenia are poor factors for OS (P < 0.001, P = 0.006) and PFS (P = 0.003, P < 0.001) in DLBCL patients. Multivariate analysis confirmed that elevated RDW value (HR = 2.026, 95%CI = 1.263–3.250, P = 0.003) and decreased PLT count (HR =1.749, 95%CI = 1.010–3.028, P = 0.046) were both independent prognostic factors. The c-index of IPI and NCCN-IPI were increased when RDW level and PLT were supplemented in our cohort.ConclusionsOur study shows that elevated RDW level and decreased PLT are independent poor prognostic factors in newly diagnosed DLBCL patients. Adding RDW and PLT to the IPI score may improve its predictive ability, and the adjusted IPI may be more powerful in predicting the survival of DLBCL patients in the rituximab era.

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