Red blood cell distribution width as a predictor of survival in nasal-type, extranodal natural killer/T-cell lymphoma
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Huaichao Luo1,*, Xiaoying Quan2,*, Xiao-Yu Song1,*, Li Zhang1,*, Yilin Yin3,*, Qiao He1, Shaolei Cai4, Shi Li1, Jian Zeng1, Qing Zhang1, Yu Gao1 and Sisi Yu2
1Department of Clinical Laboratory, Sichuan Cancer Hospital & Institute, Sichuan Cancer Center, School of Medicine, University of Electronic Science and Technology of China, Chengdu, Sichuan, China
2Department of Medical Oncology, Sichuan Cancer Hospital & Institute, Sichuan Cancer Center, School of Medicine, University of Electronic Science and Technology of China, Chengdu, Sichuan, China
3Department of Biology, The Northeastern University, Huntington Ave, Boston, MA, USA
4Radiotherapy Center, Sichuan Cancer Hospital & Institute, Sichuan Cancer Center, School of Medicine, University of Electronic Science and Technology of China, Chengdu, Sichuan, China
*These authors have contributed equally to this work
Sisi Yu, email: [email protected]
Huaichao Luo, email: [email protected]
Keywords: red blood cell distribution width (RDW), extranodal natural killer (NK)/T-cell lymphoma, predictor, survival, radiotherapy-based treatment
Received: June 12, 2017 Accepted: August 26, 2017 Published: September 30, 2017
We retrospectively enrolled 191 nasal-type, extranodal natural killer/T-cell lymphoma (ENKTL) patients newly diagnosed from 2008 to 2016 at the Sichuan Cancer Hospital, in order to evaluate the relationship between disease outcomes, demographic and clinical factors, and red blood cell distribution width (RDW). C-index, fisher’s exact test, univariate analysis, and cox regression analysis were applied. The median age of patients was 44 years and 134 (70%) were men. The cutoff of RDW was 46.2 fL determined by Cutoff Finder. Patients with RDW≤46.2 fL had significantly better progression-free survival (PFS) (3-year PFS, 80.4% vs. 63.1%; P=0.01) and overall survival (OS) (3-year OS, 83.2% vs. 65.5%; P=0.004) than those with RDW>46.2 fL. Multivariate analysis demonstrated that elevated RDW is an independent adverse predictor of OS (P=0.021, HR=2.04). RDW is an independent predictor of survival outcomes in ENKTL, which we found to be superior to both the prognostic index of natural killer lymphoma (PINK) and the Korean Prognostic Index (KPI) in discriminating patients with different outcomes in low-risk and high-risk groups (all P < 0.05). The new models combining RDW with the International Prognostic Index (IPI), KPI, and PINK showed more powerful prognostic value than corresponding original models. RDW represents an easily available and inexpensive marker for risk stratification in patients with ENKTL treated with radiotherapy-based treatment. Further prospective studies are warranted to confirm the prognostic value of RDW in ENKTL.
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