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PROGNOSTIC VALUE OF THE RED CELL DISTRIBUTION WIDTH IN PATIENTS WITH CLASSIC HODGKIN LYMPHOMA
Author(s):
Ana Knezović
,
Ana Knezović
Affiliations:
Comunity Health Centre Đakovo, Faculty of Medicine, University of Osijek, Osijek, Croatia,Đakovo,Croatia
Vlatka Periša
,
Vlatka Periša
Affiliations:
Department for Pathophysiology,Faculty of Medicine, University of Osijek, Osijek, Croatia,Osijek,Croatia;Hematology,University Hospital Centre Osijek,Osijek,Croatia
Lada Zibar
,
Lada Zibar
Affiliations:
Nephrology, Department for Pathophysiology,University Hospital Centre Osijek, Faculty of Medicine, University of Osijek, Osijek, Croatia,Osijek,Croatia
Jasminka Sinčić-Petričvić
Jasminka Sinčić-Petričvić
Affiliations:
Hematology,University Hospital Centre Osijek,Osijek,Croatia
(Abstract release date: 05/18/17) EHA Library. Periša V. 05/18/17; 182582; PB1868
Dr. Vlatka Periša
Dr. Vlatka Periša
Contributions
PDF Abstract
Abstract

Abstract: PB1868

Type: Publication Only

Background

The current gold standard for risk stratification in Hodgkin lymphoma (HL) is the International Prognostic Score. There are certain molecular and immunohistochemical prognostic markers in patients with HL, but their cost and technical constraints make such an application in routine impractical and expensive. Therefore, prognostic models for classic HL (cHL) that are inexpensive, simple, and easy to perform and interpret are needed.
The red blood cell distribution width (RDW) is associated with short- and long-term outcomes of various malignancies. The prognostic value of the RDW in cHL remains unknown.

Aims

The aim of this study was to analyze the prognostic significance of RDW in cHL patients.

Methods

We retrospectively analyzed data from 54 cHL patients diagnosed from 2005 to 2016 at the University Hospital Center Osijek, Osijek, Croatia. We evaluated disease outcome, overall survival (OS) and event-free survival (EFS), and demographic, clinical and laboratory factors affecting outcome. Univariate analysis and Cox regression analysis were used.

Results
The median age of patients was 36 years, 29 were men (54 %). Higher RDW levels (%) were found in patients with advanced Ann Arbor clinical stage (15.34 ± 2.28 vs 13.12 ± 1.3, P < 0.001) and in those with poor response to therapy (15.65 ± 3.37 (progression) vs 16.68 ± 2.09 (partial remission), 13.95±1.82 (complete remission), P = 0.008). Patients with RDW values of > 14.5 % (cutoff value calculated by receiver-operating characteristic) had a significantly worse two-year EFS (62.4 % vs 90.4 %, P = 0.009) but did not differ significantly in terms of OS (P = 0.2). Univariate analysis revealed that a high RDW (>14.5) was correlated with poor EFS (P = 0.019). Multivariate Cox regression analysis showed that RDW > 14.5 % was an independent prognostic factor for EFS (hazard ratio [HR] 3.801, 95 % confidence interval [CI] 1-14.45, P = 0.05). The RDW allowed further borderline statistically significant risk stratification in patients who were considered to be at low risk on the basis of an International Prognostic Score less than 4 (P = 0.053).

Conclusion

High baseline RDW is an independent prognostic marker of poor outcome in patients with cHL. RDW ratio is asimple, inexpensive, and independent prognostic factor for EFS that may improve the ability to identify high-risk patients with cHL. It could be an easily available and inexpensive marker for the risk stratification in patients with cHL.

Session topic: 17. Hodgkin lymphoma - Clinical

Keyword(s): Red blood cell, prognosis, Hodgkin's disease

Abstract: PB1868

Type: Publication Only

Background

The current gold standard for risk stratification in Hodgkin lymphoma (HL) is the International Prognostic Score. There are certain molecular and immunohistochemical prognostic markers in patients with HL, but their cost and technical constraints make such an application in routine impractical and expensive. Therefore, prognostic models for classic HL (cHL) that are inexpensive, simple, and easy to perform and interpret are needed.
The red blood cell distribution width (RDW) is associated with short- and long-term outcomes of various malignancies. The prognostic value of the RDW in cHL remains unknown.

Aims

The aim of this study was to analyze the prognostic significance of RDW in cHL patients.

Methods

We retrospectively analyzed data from 54 cHL patients diagnosed from 2005 to 2016 at the University Hospital Center Osijek, Osijek, Croatia. We evaluated disease outcome, overall survival (OS) and event-free survival (EFS), and demographic, clinical and laboratory factors affecting outcome. Univariate analysis and Cox regression analysis were used.

Results
The median age of patients was 36 years, 29 were men (54 %). Higher RDW levels (%) were found in patients with advanced Ann Arbor clinical stage (15.34 ± 2.28 vs 13.12 ± 1.3, P < 0.001) and in those with poor response to therapy (15.65 ± 3.37 (progression) vs 16.68 ± 2.09 (partial remission), 13.95±1.82 (complete remission), P = 0.008). Patients with RDW values of > 14.5 % (cutoff value calculated by receiver-operating characteristic) had a significantly worse two-year EFS (62.4 % vs 90.4 %, P = 0.009) but did not differ significantly in terms of OS (P = 0.2). Univariate analysis revealed that a high RDW (>14.5) was correlated with poor EFS (P = 0.019). Multivariate Cox regression analysis showed that RDW > 14.5 % was an independent prognostic factor for EFS (hazard ratio [HR] 3.801, 95 % confidence interval [CI] 1-14.45, P = 0.05). The RDW allowed further borderline statistically significant risk stratification in patients who were considered to be at low risk on the basis of an International Prognostic Score less than 4 (P = 0.053).

Conclusion

High baseline RDW is an independent prognostic marker of poor outcome in patients with cHL. RDW ratio is asimple, inexpensive, and independent prognostic factor for EFS that may improve the ability to identify high-risk patients with cHL. It could be an easily available and inexpensive marker for the risk stratification in patients with cHL.

Session topic: 17. Hodgkin lymphoma - Clinical

Keyword(s): Red blood cell, prognosis, Hodgkin's disease

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