Association of red cell distribution width with clinical outcomes in myelodysplastic syndrome
Association of red cell distribution width with clinical outcomes in myelodysplastic syndrome
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DOI：
10.1016/j.leukres.2018.02.004
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发表时间：
2018-04-01
影响因子：
2.7
通讯作者：
Nakamaki, Tsuyoshi
中科院分区：
文献类型：
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作者：
Baba, Yuta;Saito, Bungo;Nakamaki, Tsuyoshi
研究表明，红细胞分布宽度（RDW）可以提高对骨髓增生异常综合征（MDS）中红细胞形态学变化的检测，并有助于了解其对红细胞生成的贡献。本研究的目的是通过RDW分析来评估MDS患者的造血功能，并探讨RDW在临床实践中的应用。我们回顾性分析101例患者的实验室和临床资料，其中59例为难治性贫血（RA），根据法、美、英（FAB）分类。在RA患者中，RDW与血红蛋白浓度（Hb） （r(s)=-0.37， P=0.0035）和平均红细胞血红蛋白浓度（MCHC） （r(s)=-0.36， P=0.0047）呈弱负相关。另一方面，RDW与骨髓环状铁母细胞数量呈弱相关（r(s)=0.31， P=0.023）。RDW增加（>= 15.0%）与总生存期（OS）缩短相关（P=0.0086）。在伴有过多原细胞（RAEB）和RAEB转化（RAEB-t）的难治性贫血患者中，RDW对OS的影响不太明显。这些结果表明，RDW的增加可能反映了MDS中血红蛋白合成和铁代谢失调相关的红细胞生成。此外，RDW升高可能对类风湿关节炎有潜在的预后意义。
Studies showed red cell distribution width (RDW) can improve the detection of morphological changes in red blood cells and the understanding of their contribution to dyserythropoiesis in myelodysplastic syndrome (MDS). The purpose of the study was to evaluate dyserythropoiesis in MDS by RDW analysis and to explore the utility of RDW in clinical practice. We retrospectively analyzed laboratory and clinical data of 101 patients (59 patients was refractory anemia (RA) according to the French-American-British (FAB) classification). In patients with RA, RDW was showed weak inverse correlation with both hemoglobin concentration (Hb) (r(s)=-0.37, P=0.0035) and mean corpuscular hemoglobin concentration (MCHC) (r(s)=-0.36, P=0.0047). On the other hand, RDW was showed weak correlation with the number of ringed sideroblasts in bone marrow (r(s)=0.31, P=0.023). The increased RDW (>= 15.0%) was associated with shorter overall survival (OS) (P=0.0086). In patients with refractory anemia with excess blasts (RAEB) and RAEB in transformation (RAEB-t), effect of RDW on OS was less evident. These results suggested that increased RDW might reflect dyserythropoiesis, associated with deregulated hemoglobin synthesis and iron metabolism in MDS. Furthermore, increased RDW may have potential to be a prognostic significance in RA.