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

Rafsanjani, Khadijeh Arjmandi; Falahati, Vahid; Kiumarsi, Azadeh; Moghaddam, Shabnam Jalili; Fallahi, Mahsa

doi:10.21767/2576-3903.100011

Cited by 3 publications

(4 citation statements)

References 25 publications

(29 reference statements)

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“…we did not find any prognostic impact of RDW on either OS or DFS in adult ALL. This finding was consistent with a study exploring the prognostic impact of RDW in children ALL [15]. Although this was a single-center retrospective extended analysis, pretreatment grade 4 thrombocytopenia was an independent negative prognostic factor of both overall survival and disease-free survival in adults with acute lymphoblastic leukemia.…”

Section: Resultssupporting

confidence: 90%

Pretreatment grade 4 thrombocytopenia is an independent prognostic factor in adult acute lymphoblastic leukemia: an extended analysis of a single-center retrospective study

et al. 2020

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Objectives: Low pretreatment platelet count is negatively associated with overall survival (OS) of certain subtypes of acute lymphoblastic leukemia (ALL). However, the prognostic impact of the grade of thrombocytopenia on OS and disease-free survival (DFS) has never been explored. Methods: We conducted an extended analysis of a retrospective study. Newly diagnosed adults with ALL was enrolled in this study. The grade of thrombocytopenia was evaluated in accordance with the Common Terminology Criteria for Adverse Events (CTCAE) version 3.0. Prognostic impacts were assessed by the hazard ratios (HRs) and 95% confidence intervals (CIs) obtained from univariate and multivariate Cox proportional hazards regression analyses. Results: A total of 90 participants were included in this study. There were 18 cases with grade 4 thrombocytopenia among the 71 participants presented with thrombocytopenia of any grade. Both univariate and multivariate Cox regression analyses suggested the independent negative prognostic impact of grade 4 thrombocytopenia on both OS (HR = 4.73, 95% CI = 1.95-11.52) and DFS (HR = 9.82, 95% CI = 3.14-30.76) of adult ALL, using the cohort of patients with no thrombocytopenia as a reference. In addition, treatment regimen, cytogenetic profile, time to treatment, and platelet count were independent prognostic factors of the OS. We also found that treatment regimen, cytogenetic profile, and peripheral blood blast percentage were independent prognostic factors of the DFS. Conclusion: Grade 4 thrombocytopenia was a negative prognostic factor for both overall survival and disease-free survival of adults with acute lymphoblastic leukemia.

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Section: Resultssupporting

confidence: 90%

Pretreatment grade 4 thrombocytopenia is an independent prognostic factor in adult acute lymphoblastic leukemia: an extended analysis of a single-center retrospective study

et al. 2020

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“…RBCs, hemoglobin and Platelets exhibited low count levels when compared with normal reference range as shown in Table 4, whereas WBC count was high in leukemia cases. Low levels of RBC, 36 hemoglobin Okuku et al 37, 38 ); platelet 2,17,39 are very common in leukemic subjects whereas, high WBC count which is one of the characteristics of leukemia is also observed by other research workers 17,40,41 . WBC differential count also showed statistically significant values, when compared with normal reference value, neutrophil, monocyte, and eosinophil showed lower mean values, whereas lymphocytes level was high.…”

Section: Resultsmentioning

confidence: 67%

Biochemical and Hematologic Profiles in B-Cell Acute Lymphoblastic Leukemia Children

Khalid

Ahmed

Hasnain

2023

Journal of Pediatric Hematology/Oncology

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B-cell acute lymphoblastic leukemia is the most common type of leukemia found in children. Timely diagnosis, white blood cell count, age of onset, and sex are considered the most important prognostic factors in childhood leukemia. Hematological and biochemical profiles are crucially important to infer the health of leukemia patient pre-chemotherapy and post-chemotherapy treatment. In the current study 200 cases were taken and evaluated for hematological (complete blood count and white blood differential count) and biochemical parameters (renal function tests, liver function tests, serum electrolytes and serum proteins) by comparison with normal reference values. Most of the cases were male under 5 years of age. Hematology parameters including red blood cells, hemoglobin and platelet levels were relatively low whereas white blood cells level was high in cases as compared with normal reference value. Sex-wise and age-wise comparison of biochemical profile showed significant difference among B-cell acute lymphoblastic leukemia cases whereas hematological profile did not show any visible difference.

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“…When specifically analyzing RDW and mortality among pediatric leukemia patients, half of the 12 patients who died (14.5% of the study population) had an RDW over the cut-off point of 15.7 which was not statistically significant (p ¼ 0.09). 4 Lastly, a study by Khanbabaee et al showed that though RDW correlated significantly with mortality on the day of admission to the PICU, specifically for patients diagnosed with sepsis, correlation waned over time and did not appear to predict mortality by day 8. 13 Multiple pathophysiological connections exist between dyserythropoiesis and clinical outcomes, and thus are reasonable hypotheses that support the results determined from this meta-analysis.…”

Section: Discussionmentioning

confidence: 98%

“…Nutritional deficiencies and inflammation coupled with comorbidities, such as hypoxemia and intravascular erythrocyte destruction, may further exacerbate marrow stress and reflect in the RDW value. Elevated RDW has been shown to correlate with mortality rates in adult and pediatric patients [1][2][3][4][5][6][7][8] highlighting the utility of RDW as a surrogate marker for the pathophysiology of critical illness.…”

Section: Introductionmentioning

confidence: 99%

A Meta-analysis of the Utility of Red Cell Distribution Width as a Biomarker to Predict Outcomes in Pediatric Illness (PROSPERO CRD42020208777)

Murphy

Orgel

Koek

et al. 2021

J Pediatr Intensive Care

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Red cell distribution width (RDW) is an average of the variation in red blood cell (RBC) sizes reported on a complete blood count. An elevated RDW indicates a pathological process that is affecting erythropoiesis. Studies showed that as the severity of disease process increases, the RDW often increases as well. Particularly in resource-limited countries, RDW has been studied as an outcome predictor for conditions in a variety of disciplines and is offered as an adjunct monitoring tool that is cost effective, readily available, and indicative of pathological processes amenable to intervention. Particularly in pediatric critical care settings, RDW has been shown to be a reliable tool for surveillance of disease states such as sepsis. Despite the increased attention of RDW as a marker for disease outcome, collective evaluation on the utility of RDW as a marker for outcome in pediatric critical care settings is lacking. We offer a systematic review and meta-analysis of published studies to assess the ability of RDW to predict illness severity and mortality among pediatric critical care patients. Among eight studies of over 4,800 patients, we found over a two-fold increase in odds for mortality in critically ill children whose RDW was above 15.7%. This is the first systematic review of RDW being used to predict mortality in critically ill children and findings of this study may prompt early intervention in the pediatric critical care setting.

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

Cited by 3 publications

References 25 publications

Pretreatment grade 4 thrombocytopenia is an independent prognostic factor in adult acute lymphoblastic leukemia: an extended analysis of a single-center retrospective study

Pretreatment grade 4 thrombocytopenia is an independent prognostic factor in adult acute lymphoblastic leukemia: an extended analysis of a single-center retrospective study

Biochemical and Hematologic Profiles in B-Cell Acute Lymphoblastic Leukemia Children

A Meta-analysis of the Utility of Red Cell Distribution Width as a Biomarker to Predict Outcomes in Pediatric Illness (PROSPERO CRD42020208777)

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