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

Abstract

Background: Elevated 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. Methods: Healthy 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. Results: Kaplan-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. Conclusions: Our 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.

Lenfoma Hastalarin

“…In the last studies, it was found that the decreased PLT level predicts a worse prognosis in lymphoma patients (10,21,22). In our study, there was a statistically significant relationship between the PLT level and mortality in patients with NHL and our study showed that the low PLT level in NHL patients indicates a worse survival rate, but no significant correlation was found between the PLT level and mortality and OS in patients with HL.…”

Novel prognostic predictor of haemoglobin–platelet index in diffuse large B‐cell lymphoma, not otherwise specified: Anaemia and thrombocytopenia are associated with IL‐6 production in lymphoma cells

“…35,37 However, these findings were denied in other studies. 19,36,38,39 In our analysis, we found that thrombocytopenia but not anaemia was associated with BM involvement. These inconsistent findings might result from the different cut-off values of BM involvement of lymphoma cells.…”

Red blood cell distribution width to platelet ratio substantiates preoperative survival prediction in patients with newly-diagnosed glioblastoma

“…RDW has also been found to be a prognosticator in a wide variety of cancers [37][38][39]. Where RDW has already gained prognostic value in predicting overall survival in patients with glioblastoma [18], the ratio formed from it together with platelet count (RPR) is experiencing increasing interest in other diseases [12,13,40,41]. Platelet count as such is of unsteady predictive value.…”

“…This is due to the fact that the normal distribution of platelet counts contains a range and not a cut-off value, so that the individually adjusted cut-off values in the individual studies are not comparable. In glioblastoma, an increase in platelet count was previously assumed to be an unfavorable prognostic feature [ 41 ]. This fits with the experience in most solid tumors that the elevated platelet count plays a critical role in progression and metastasis [ 42 – 44 ].…”