Prognostic Role of RDW in Hematological Malignancies: A Systematic Review and Meta-Analysis

Cancer Cell Int. 2018 Apr 23;18:61. doi: 10.1186/s12935-018-0558-3. eCollection 2018.


Background: Red blood cell distribution width (RDW), a biomarker for discrimination of anemia, has been recently identified as a prognostic factor in various types of cancer. Here we performed a meta-analysis in order to assess the correlation between RDW and the survival outcomes in patients with hematologic malignances.

Patients/methods: We systematically searched PubMed, Embase, and ISI Web of Science for relevant studies, to investigate the prognostic significance of RDW in hematological malignancies. Odds ratios or hazards ratios (HRs) with corresponding 95% confidence intervals (CIs) are pooled to estimate the association between RDW and clinicopathological parameters of patients with hematologic malignances.

Results: Seven trials with 1031 patients suffering from hematological malignancies were included in the meta-analysis, and the results indicated that increased pretreatment RDW predicted poor overall survival (HR = 2.35, 95% CI 1.70-3.24), poor progress-free survival (HR = 2.44, 95% CI 1.70-3.49) and poor event-free survival (EFS) (HR = 3.15, 95% CI 1.59-6.25). Furthermore, the similar results were observed in subgroup analysis stratified by cancer type, such as multiple myeloma, and diffuse large B cell lymphoma, etc.

Conclusions: As for hematologic malignances, patients with higher RDW are more likely to have poorer prognosis than those with lower RDW.

Keywords: Hematologic malignances; Meta-analysis; Prognosis; Red blood cell distribution width.