Assessment of red blood cell distribution width as a prognostic marker in chronic lymphocytic leukemia

Abstract

Red blood cell distribution width (RDW) is a quantitative measure of the variability in size of circulating erythrocytes. It was recently reported that RDW is a prognostic factor for infection diseases, cardiovascular and pulmonary diseases, as well as some neoplasms. Moreover, RDW is remarkably strong predictor of longevity, including all causes of death, for adults aged 45 years and older. To explain this occurrence it was proposed that persistent IGFs/mTOR signaling is one of the factors that play a role in affecting the RDW and mortality.The above observations induced us to analyze the prognostic role of RDW in chronic lymphocytic leukemia (CLL) being the most frequent type of adult leukemia in Western countries. The obtained results have shown that RDW may be considered as a potential CLL prognostic marker. Elevated RDW level at the moment of diagnosis was associated with advanced disease and presence of other poor prognostic factors. It is also connected with overall survival indicating shorter time in patients with elevated RDW. It is possible that the presently observed correlation between mortality and RDW of the CLL patients is affected by their metabolic (IGF-1/mTOR driven)- rather than chronological- aging. The patients with high level of RDW are expected to have an increased persistent level of IGF-1/mTOR signaling. Within the framework of personalized therapy, these CLL patients therefore would be expected to be more sensitive to the treatment with mTOR inhibitors.

Evaluation of complete blood count parameters to predict endometrial cancer

“…In recent years, many studies investigating the relationship between RDW and cardiovascular disease and cancer were performed. RDW was proved to be an independent prognostic factor for many cancers such as lung cancer, prostate cancer, and chronic lymphocytic leukemia . In our study, we found that RDW measurements were significantly lower in patients with endometrial carcinoma compared to patients with endometrial hyperplasia and healthy controls.…”

“…Mean platelet volume (MPV) is an important inflammatory marker indicating platelet activation . Until today, the relationship between hematological parameters such as MPV, RDW, NLR, PLR, PDW were investigated, diagnostic, and prognostic features of these parameters with their role in metastatic activities of cancer were evaluated …”

The Association between Red Cell Distribution Width and Mortality in Pediatric Acute Lymphoblastic Leukemia

“…In view of the fact that RDW level is indicative of abnormal red blood cell survival and that it correlates with the presence of inflammatory states [18,19], this parameter has been investigated as prognostic factor in hematological malignancies [20][21][22][23][24][25][26]. Some recent studies and a meta-analysis have demonstrated that RDW is a potent predictor of all-cause mortality, including cancer-related deaths [4,11].…”

Red cell distribution width and cancer

“…Accordingly, since RDW level indicates abnormal red blood cell survival but it correlates also with the presence of severe systemic inflammatory state, undernutrition and inadequate production of EPO (3,25), this parameter has been investigated as prognostic factor and marker of disease activity in hematological malignancies [i.e., lymphocytic and myeloid leukemia, multiple myeloma, lymphoma and myelodysplastic syndrome (MDS)] (26)(27)(28)(29)(30)(31)(32)(33).…”

“…Recently, Podhorecka et al, with the aim to investigate RDW as a marker of prognosis in patients with chronic lymphocytic leukemia (CLL), enrolled 66 previously untreated persons (median age, 63 years; range, 38-85 years) with CLL diagnosis (27). They reported that RDW is in correlation with prognostic factors such as clinical stadium of the disease and expression of ZAP-70 and CD38, both indicators for immunoglobulin heavy chain genes mutations.…”