Is RDW a clinically relevant prognostic factor for newly diagnosed multiple myeloma? A systematic review and meta-analysis

Abstract

Background Multiple myeloma (MM) is an incurable plasma cell malignancy. Red cell distribution width (RDW) is a prognostic marker in various diseases, solid tumors, and hematologic neoplasms, but its prognostic significance in MM is controversial. In this study, we aimed to assess the relationship between RDW and the clinical prognosis of MM patients through a meta-analysis. Methods Relevant literature were retrieved from PubMed, Embase, and Web of Science databases according to PRISMA guideline. All relevant parameters were extracted and combined for statistical analysis. The effect size was presented as hazard ratio (HR)/odds ratio (OR) and 95% confidence interval (CI). HR/OR > 1 in MM patients with high RDW suggested a worse prognosis. Heterogeneity test evaluation was performed using Cochran's Q test and I2 statistics. A Pheterogeneity < 0.10 or I2 > 50% suggested significant heterogeneity. P < 0.05 was considered statistically significant. Statistical analysis was performed using Stata 12.0 software. Results 8 articles involving 9 studies with 1165 patients were included in our meta-analysis. Our results suggested that elevated RDW is significantly associated with poor prognosis in MM (OS: HR = 1.91, 95%CI: 1.48–2.46; PFS: HR = 2.87, 95% CI: 2.02–4.07). A significant correlation was not found between RDW and International Staging System (ISS) staging (ISS III VS ISS I-II: OR:1.53; 95%CI:0.97–2.42). Conclusion Our results suggested that RDW is a robust predictor of newly diagnosed MM outcomes.

Red blood cell distribution width is a useful biomarker to predict bleeding and thrombosis risks in patients with immune thrombocytopenic purpura

“…Elevated RDW has been associated not only with vascular risks, but also with the prognosis and risks of complications of various cancers, such as breast, lung, and esophageal cancers [44][45][46][47][48]. Recently, RDW has been reported as a potentially useful biomarker to predict prognosis and complication risks in hematologic cancers, such as diffuse large B-cell lymphoma, primary central nervous system lymphoma, multiple myeloma and chronic myeloid leukemia [49][50][51][52][53]. The limitations of our study include its single-center, retrospective design involving patients with heterogenous backgrounds and potential confounding factors that may have affected outcomes.…”

Changes in RDW according to prognostic predictors in newly diagnosed multiple myeloma

“…Subsequently, other authors confirmed the role of RDW in predicting outcome of MM patients, in short- and long-distance 16 , 17 , and still others hypothesized a role of this erythrocyte index in prediction of clinical response to treatment 18 , 19 . Moreover, a recent systemic review and a meta-analysis of all publications regarding the trend of RDW in multiple myeloma was carried out, with the conclusion that this index is a significant predictor of outcomes in new diagnosed multiple myeloma patients 20 .…”

Association of mean RDW values and changes in RDW with in‐hospital mortality in ventilator‐associated pneumonia (VAP): Evidence from MIMIC‐IV database

“…[8][9][10][11] To date, increasing evidence has shown that RDW is associated with worse outcomes in many diseases, including acute exacerbation of chronic obstructive pulmonary disease, COVID-19, multiple myeloma, heart failure, spontaneous intracerebral hemorrhage, and community-acquired pneumonia. [12][13][14][15][16][17] Recently, Deniz et al 18 revealed the significant predictive value of RDW in mortality among ICU patients. However, the relationship between RDW and outcome of patients with VAP remains unclear.…”

“…Numerous studies have demonstrated that RDW is associated with aging, inflammation, oxidative stress, nutritional deficiency, erythropoiesis impairment, and telomere shortening 8–11 . To date, increasing evidence has shown that RDW is associated with worse outcomes in many diseases, including acute exacerbation of chronic obstructive pulmonary disease, COVID‐19, multiple myeloma, heart failure, spontaneous intracerebral hemorrhage, and community‐acquired pneumonia 12–17 . Recently, Deniz et al 18 revealed the significant predictive value of RDW in mortality among ICU patients.…”