Prognostic value of red blood cell distribution width in patients with Waldenstrom macroglobulinemia
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摘要:
目的：探索红细胞分布宽度（red blood cell distribution width，RDW）在华氏巨球蛋白血症（Waldenstrom macroglobulinemia，WM）患者中的预后价值。方法：回顾性分析2009年6月—2018年9月在南京医科大学第一附属医院诊断为WM的患者资料。依据受试者工作特征（receiver operating characteristic，ROC）曲线，确定RDW预测无进展生存期（progression-free survival，PFS）和总生存期（overall survival，OS）的最佳截断值。单因素及多因素Cox生存分析探索PFS和OS的影响因素。结果：78例初诊WM患者纳入本研究，ROC曲线确定RDW的最佳截断值为16.4%。中位随访39.5个月，初诊时高RDW水平WM患者具有更差的生存结局。多因素分析显示，高RDW水平是影响PFS和OS的独立不良因素。此外，RDW联合改良国际预后积分系统能够改善WM的预后分层。结论：RDW为临床上简便可行的参数，可用来预测WM的预后。
Abstract:
Objective：This study investigated the clinical significance of red blood cell distribution width（RDW）in Waldenstrom macroglobulinemia（WM）. Methods：Data of patients diagnosed with WM in the First Affiliated Hospital of Nanjing Medical University from June 2009 to September 2018 were retrospectively analyzed. The best cut-off value of RDW was determined by receiver operating characteristic（ROC）curve. Univariate and multivariate analysis were performed to find out the factors of progression-free survival（PFS）and overall survival（OS）. Results：Seventy-eight patients were finially enrolled in this study. The ROC curve indicated that 16.4% was the best cut-off value to predict survival outcomes. The median follow-up time was 39.5 months，patients with a high level of RDW（＞16.4%）had worse survival outcome. Multivariate analysis revealed that a high level of RDW was an independent risk factor for PFS and OS. Furthermore，a high level of RDW together with the revised international prognostic score system for WM improved the prognostic capacity of WM. Conclusion：RDW is a feasible clinical parameter which could be used to predict the prognosis of WM.
