Evaluation of clinical efficacy and prognosis of luspatercept in the treatment of myelodysplastic syndrome based on red blood cell distribution width and Cyr61
10.3781/j.issn.1000-7431.2025.2408-0476
- VernacularTitle:红细胞分布宽度与Cyr61判断罗特西普治疗骨髓增生异常综合征的临床疗效和预后
- Author:
Gengrong LIU
1
;
Wenbin LI
1
;
Guihu LI
1
Author Information
1. 湖北省潜江市中心医院肿瘤血液科,湖北 潜江 433100
- Publication Type:Journal Article
- Keywords:
Myelodysplastic syndrome;
Red blood cell distribution width;
Cysteine-rich 61;
Luspatercept;
Efficacy;
Prognosis
- From:
Tumor
2025;45(3):276-286
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To explore the associations between red blood cell distribution width and cysteine-rich 61(Cyr61)with efficacy and prognosis of luspatercept in the treatment of myelodysplastic syndrome.Methods:From August 2020 to August 2023,140 patients with myelodysplastic syndrome who received luspatercept treatment were selected.They were divided into effective group(104 cases)and ineffective group(36 cases)based on clinical efficacy,and into survival group(118 cases)and death group(22 cases)based on prognosis.Logistic regression analysis was used to investigate the correlation between red blood cell distribution width and Cyr61 with prognosis.Kaplan-Meier method was employed to plot survival curves,and receiver operating characteristic(ROC)curves were used to analyze the value of red blood cell distribution width and Cyr61 in evaluating the efficacy and prognosis of luspatercept treatment for myelodysplastic syndrome.Results:Compared with the ineffective group,the platelet count,neutrophil count,and hemoglobin level were significantly lower(P<0.05)in the effective group,while the platelet distribution width,red blood cell distribution width,and Cyr61 level were significantly higher(P<0.05).Compared with the ineffective group,the red blood cell distribution width and Cyr61 level were significantly lower(P<0.05)in the effective group as the efficacy improved.The red blood cell distribution width and Cyr61 level were positively correlated with ineffectiveness.Especially when the red blood cell distribution width was>20.86%and Cyr61 was>61.65 pg/mL,the risk of treatment non-response in patients with myelodysplastic syndrome increased significantly with the increase in red blood cell distribution width and Cyr61 level.Compared with the survivors,the platelet count,neutrophil count,and hemoglobin level were significantly lower(P<0.05),while the platelet distribution width,red blood cell distribution width,and Cyr61 level were significantly higher(P<0.05).The logistic regression analysis results showed that the red blood cell distribution width[odds ratio:0.694(95%confidence interval:0.504-0.812);P<0.05]and Cyr61[odds ratio:0.543(95%confidence interval:0.405-0.653);P<0.05]were independent risk factors for prognosis.The Kaplan-Meier analysis results showed that the survival rate significantly decreased with the increase in red blood cell distribution width and Cyr61 level(P<0.05).The receiver operating characteristic curve analysis results showed that both red blood cell distribution width and Cyr61 had certain significance for predicting the efficacy and prognosis of luspatercept treatment for myelodysplastic syndrome(P<0.05,area under the curve>0.75),and the combination of the two had the highest accuracy in predicting efficacy and prognosis(P<0.05,area under the curve>0.90).Conclusion:With the increase in red blood cell distribution width and Cyr61 levels,the risk of treatment ineffectiveness and death in patients with myelodysplastic syndrome receiving luspatercept therapy significantly increases.Clinically,the combination of red blood cell distribution width and Cyr61 can effectively evaluate the efficacy and prognosis of luspatercept in the treatment of myelodysplastic syndrome.
