The Value Of Red Blood Cell Distribution Width(RDW)and Chronic Myeloid Leukemia(CML-CP)in Diagnosis,treatment And Prognosis

Objective:.The purpose of this study was to investigate the value of red blood cell in the diagnosis,treatment and prognosis of patients with chronic myeloid leukemia.Methods:A retrospective analysis of 64 newly diagnosed CML-CP patients admitted to the Department of Hematology of the Affiliated Hospital of Youjiang University for Nationalities from October 2013 to May 2019 with bone marrow aspiration confirmed.The basic and clinical data of all patients were complete,and their gender,age and relevant laboratory tests were collected.All patients received imatinib as initial treatment within 6months of diagnosis and were followed up for at least 3 months.Sixty-four normal subjects were used as the control group.The control group was derived from the health check-ups in our hospital.All patients underwent blood tests and liver and kidney function tests.The deadline for follow-up of included patients was October 31,2019.SPSS 23.0 software was used for statistical analysis.ROC curve was used to analyze the value of RDW in the diagnosis of CML-CP.Kaplan-Meier method was used to estimate OS,PFS,and EFS.For comparison of survival rates between the two groups,Log-rank test was used.Results:(1)Among the 64 newly diagnosed CML-CP patients,there were 37 males and27 females.The ratio of males to females was 1.37 to 1.The minimum age of onset is 23 years,the maximum age of onset is 71 years old,and the median age of 47years.There were 64 cases in the healthy control group,there were 39 males and 25 females.The ratio of males to females was 1.56 to 1.The minimum age of onset is 28 years,the maximum age of onset is 70years old,and the median age of 48years.There was no significant difference in gender and age between the two groups(P>0.05).(2)Among 64 CML-CP patients patients,Leukocytes increased in 64 cases(100%),of which 40 patients(62.5%)exceeded 100×10~9/L.There were35 cases(54.69%)and 29 cases(45.31%)of platelet hyperplasia and normal.Red blood cells were normal and decreased in 24 cases(37.5%)and 40 cases(62.5%).(3)The RDW value of newly diagnosed CML-CP patients was significantly higher than that of the healthy control group(18.46±3.24 VS 13.39±0.87).The mean red blood cell volume(MCV),hemoglobin content(MCH)and mean hemoglobin concentration(MCHC)in the CML-CP group and the healthy control group were(91.50±4.06 VS 92.66±3.95;29.73±1.39 VS 30.25±1.6;334.98±10.89 VS 338.25±7.98),the comparison of the above three indicators between groups was not statistically significant(P>0.05).The HB of CML-CP group was significantly lower than that of healthy control group(91.84±9.79 VS 128.47±8.81),and there was a significant difference between the two groups(P<0.001).(4)According to the ROC curve analysis,the RDW value is of diagnostic value for CML-CP patients.(5)The RDW values of newly diagnosed CML-CP patients were correlated with gender,WBC count,hemoglobin level,MCH,MCHC,splenomegaly and EUTOS scores(P<0.05);were not associated withage,MCV,percentage of basophils,percentage of eosinophils,platelet count,Sokal,and Hasford scores risk stratification(P>0.05).(6)Among the 64 newly diagnosed CML-CP patients,the RDW values at 3 months,6 months,and 12 months were lower than those at the initial diagnosis(15.93±2.11 VS 18.46±3.24;13.93±1.06 VS 18.46±3.24;13.44±0.90 VS 18.46±3.24)(P<0.001).(7)Among the 64 patients with newly diagnosed CML-CP,patients in the high RDW group had a poorer response to IM than those in the low RDW group,especially in response to treatment at 3 and 6 months(P<0.05),independent of 12 months of treatment response(P>0.05).(8)The median follow-up period was 38.5 months(range=3-72 months).The5-year OS of the high RDW and low RDW groups was 69.3%and 100%,respectively,and the comparison between the two groups of patients was statistically significant(P=0.046).The 5-year PFS in the high RDW and low RDW groups was 64.8%and 100%,respectively.The comparison between the two groups was statistically significant(P=0.034).The 5-year EFS of the high RDW and low RDW groups were 53.5%and 100%,respectively.The comparison between the two groups of patients was statistically significant(P=0.013).Conclusion:(1)RDW has the value of auxiliary diagnosis for CML-CP.(2)The RDW value of newly diagnosed CML-CP patients can predict IM treatment response.The higher the RDW value,the worse the IM treatment response,especially related to the early treatment response.(3)The RDW value of newly diagnosed CML-CP patients can predict the efficacy and prognosis.The higher the RDW value,5-year OS,PFS and EFS.