Turgutkaya Atakan, Akın Nesim, Sargın Gökhan, Bolaman Zahit, Yavaşoğlu İrfan
Adnan Menderes University Hospital, Aytepe Mevki, Efeler, Aydın, Turkey.
Adnan Menderes University Hospital, Aytepe Mevki, Efeler, Aydın, Turkey.
Hematol Transfus Cell Ther. 2022 Jul-Sep;44(3):332-335. doi: 10.1016/j.htct.2020.11.007. Epub 2021 Jan 29.
The myelodysplastic syndrome (MDS) represents a group of hematopoietic neoplasms that is characterized by clonal hematopoiesis, cytopenia and abnormal cellular maturation. Red cell distribution width (RDW) refers to the variation degree of erythrocyte size and it is a reflection of anisocytosis. Higher values have been linked to adverse outcomes, such as increased mortality, vascular events, kidney and liver disease and demonstrated to harbor poor prognosis in solid and hematological malignancies. The RDW value can be used as a contributing parameter for MDS diagnosis, as well as its prognosis. In this study, we essentially aimed to demonstrate the correlation between the RDW and MDS prognostic indexes.
Ninety-four MDS patients at the Aydın Adnan Menderes University Hematology Division were included in the study. The correlations between the RDW and laboratory values (either lactate dehydrogenase, albumin, globulin or ferritin) and the RDW prognostic scoring indexes (IPSS, WPSS, IPSS-R and LR-PSS) were investigated. The PASW for Windows, version 21.0 (SPSS Inc., Chicago, IL, USA), was used for statistical assessment. A p-value below 0.05 was the cut-off for the statistical significance.
The mean age of all the patients was 73 ± 10 years. Patients were observed for 41.88 ± 25 months. The mean RDW value for all cases was 15.5 ± 2.39. We found a statistically significant difference of survival between RDW values below and above 15.5% (p = 0.016). A significant difference was also observed according to the prognostic scoring indexes (see below).
An increase in RDW is probably related to dysplasia in the MDS and this constitutes a possible explanation for the poor outcome. Prognostic indexes might incorporate the RDW as a parameter in the future.
骨髓增生异常综合征（MDS）是一组造血系统肿瘤，其特征为克隆性造血、血细胞减少和细胞成熟异常。红细胞分布宽度（RDW）指红细胞大小的变异程度，反映红细胞大小不均一性。较高的RDW值与不良预后相关，如死亡率增加、血管事件、肾脏和肝脏疾病，并且在实体肿瘤和血液系统恶性肿瘤中均显示预后不良。RDW值可作为MDS诊断及其预后的一个参考参数。在本研究中，我们主要旨在证明RDW与MDS预后指标之间的相关性。
本研究纳入了艾登阿德南·门德雷斯大学血液科的94例MDS患者。研究了RDW与实验室指标（乳酸脱氢酶、白蛋白、球蛋白或铁蛋白）以及RDW预后评分指标（IPSS、WPSS、IPSS-R和LR-PSS）之间的相关性。使用Windows版PASW 21.0（SPSS公司，美国伊利诺伊州芝加哥）进行统计评估。p值低于0.05为具有统计学意义的临界值。
所有患者的平均年龄为73±10岁。对患者进行了41.88±25个月的观察。所有病例的平均RDW值为15.5±2.39。我们发现RDW值低于和高于15.5%的患者生存率存在统计学显著差异（p = 0.016）。根据预后评分指标也观察到了显著差异（见下文）。
RDW升高可能与MDS中的发育异常有关，这可能是预后不良的一个解释。预后指标未来可能会将RDW纳入作为一个参数。
