Prognostic significance of the red blood cell distribution width in diffuse large B-cell lymphoma patients

This study examined the prognostic value of the baseline red blood cell distribution width (RDW) in diffuse large B cell lymphoma (DLBCL) patients. The associations between RDW and clinical characteristics were assessed in 161 DLBCL patients from 2005 to 2016. The log-rank test, univariate analysis, and Cox regression analysis were used to evaluate the relationship between RDW and survival. A RDW of 14.1% was considered to be the optimal cut-off value for predicting prognosis. A high RDW was associated with more frequent B symptoms (P=0.001), a higher International Prognostic Index score (P=0.032), more extranodal sites of disease (P=0.035), and significantly lower Eastern Cooperative Oncology Group performance status (P=0.031). The log-rank test demonstrated that patients with a high RDW had a shorter overall survival (OS) (2-year OS rate, 53.6% vs. 83.6%, P<0.001) and progression-free survival (PFS) (2-year PFS rate, 44.7% vs. 81.8%, P<0.001). The multivariate analysis demonstrated that RDW >= 14.1% was an independent predictor of OS (odds ratio [ OR] = 0.345, P<0.001) and PFS (OR = 0.393, P=0.001). We demonstrated that a high RDW predicted an unfavorable prognosis in patients with DLBCL.