Correlation between red blood cell distribution width/platelet count and prognosis of newly diagnosed diffuse large B-cell lymphoma

Blood Res. 2023 Dec 31;58(4):187-193. doi: 10.5045/br.2023.2023156. Epub 2023 Nov 30.

Abstract

Background: Red blood cell distribution width/platelet count ratio (RPR) is a reliable prognostic assessment indicator for numerous diseases. However, no studies to date have examined the relationship between RPR and the prognosis of diffuse large B-cell lymphoma (DLBCL). Therefore, this study aimed to investigate the correlation between RPR and the clinical characteristics and prognosis of patients with diffuse large B-cell lymphoma.

Methods: We retrospectively studied 143 patients with newly diagnosed DLBCL and used the median value as the RPR threshold. We also investigated the correlation of pretreatment RPR level with clinical characteristics and its impact on DLBCL prognosis.

Results: Using the median value as the cut-off, patients with DLBCL were divided into a low RPR group (<0.0549) and a high RPR group (≥0.0549). Patients in the high RPR group were older, had a later Ann Arbor stage, were prone to bone marrow invasion, and had a higher National Comprehensive Cancer Network International Prognostic Index score (P<0.05). A survival analysis showed that progression-free survival (PFS) (P=0.003) and overall survival (OS) (P<0.0001) were significantly shorter in the high versus low RPR group. A multifactorial Cox analysis showed that bone marrow invasion and elevated lactate dehydrogenase (LDH) were separate risk factors for PFS (P<0.05), while an RPR ≥0.0549 and elevated LDH were separate risk factors for OS (P<0.05).

Conclusion: A high RPR (≥0.0549) in patients with newly diagnosed DLBCL is an independent risk factor for a poor prognosis.

Keywords: Diffuse large B-cell lymphoma; Platelet count; Prognosis; Red blood cell distribution width.

Grants and funding

*This study was partially supported by a grant from the National Natural Science Foundation of China (no. 81971508) and the Henan Province Science and Technology Tackling project (no. 222102310101).