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Red blood cell distribution width is a simple and novel biomarker for survival in light-chain amyloidosis

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Abstract

Red blood cell distribution width (RDW) has been used for the differential diagnosis of anemia, but high RDW may also be associated with several human disorders. We evaluated the prognostic relevance of RDW in patients with light-chain (AL) amyloidosis. We retrospectively analyzed all patients with AL amyloidosis who were newly diagnosed at the Japanese Red Cross Medical Center between December 2011 and June 2018. RDW was evaluated in 94 patients; 48% (n = 45) of patients had a high RDW (≥ 13.8%) and 52% (n = 49) had a low RDW (< 13.8%). Overall survival (OS) was significantly lower in patients with a high RDW (P < 0.001). On multivariate analysis, increased RDW was an independent predictor for OS. Even in patients without cardiac amyloidosis, the OS was significantly lower in the high-RDW group (P = 0.0064). The survival rate of high-RDW patients without cardiac involvement was as poor as that of patients with cardiac involvement. In addition, in patients with revised Mayo stage I or a normal level of N-terminal pro-B-type natriuretic peptide, high RDW was negatively correlated with OS (P = 0.0086, 0.025). RDW is a simple and strong predictor of early death, and is a prognostic biomarker in patients with AL amyloidosis without cardiac involvement.

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Acknowledgements

TY and KO designed the study. TY, KO, JN, YU, KS, KM, MO, YY, YA, NT, TI and KS recruited patients and collected samples. TY and KO analyzed the data and wrote the manuscript. All authors discussed the data and critically commented on the manuscript. This study did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.

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Authors and Affiliations

  1. Department of Hematology, Japanese Red Cross Medical Center, 4-1-22 Hiroo, Shibuya-ku, Tokyo, Japan

    Takao Yogo, Kiyoshi Okazuka, Junichiro Nashimoto, Yui Uto, Kota Sato, Kanji Miyazaki, Mizuki Ogura, Yumiko Yoshiki, Yu Abe, Nobuhiro Tsukada, Tadao Ishida & Kenshi Suzuki

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  1. Takao Yogo
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  2. Kiyoshi Okazuka
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Correspondence to Takao Yogo.

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Conflict of interest

K. Suzuki received personal fees from Janssen, Novartis, Celgene, Ono Pharmaceuticals, Takeda, Fujimoto Pharmaceuticals and SRL. T. Ishida received personal fees from Janssen, Celgene, Ono Pharmaceuticals and Takeda. The other authors have no conflicts of interest to declare.

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Yogo, T., Okazuka, K., Nashimoto, J. et al. Red blood cell distribution width is a simple and novel biomarker for survival in light-chain amyloidosis. Int J Hematol 110, 431–437 (2019). https://doi.org/10.1007/s12185-019-02692-0

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  • DOI: https://doi.org/10.1007/s12185-019-02692-0

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