Analysis of Mean Corpuscular Volume and Red Cell Distribution Width in Patients with Aplastic Anemia

Abstract

To explore the characteristics of hemogram in patients with aplastic anemia (AA), especially mean corpuscular volume (MCV) and red cell distribution width (RDW). We examined the blood routine of 180 new-onset AA patients and used 166 patients with myelodysplastic syndrome (MDS) as controls. Among the 180 AA patients, 105 (58.3%) were diagnosed with severe AA (SAA), while 75 (41.7%) were diagnosed with non-severe AA (NSAA). Compared to MDS, patients with SAA generally had unfavorable hemogram, including significantly lower white blood cell (WBC), absolute neutrophil count (ANC), hemoglobin (Hb), platelet (PLT) and reticulocyte counts (RET). However, WBC, ANC and lymphocyte counts were higher in the NSAA group than in the MDS group; Hb and Ret were comparable between the two groups. 8.5% of SAA patients and 58.1% of NSAA patients presented with macrocytic anemia, whereas 25.7% of SAA and 64.0% of NSAA had a high RDW. In the MDS group, 54.7% of patients presented with macrocytic anemia, and 84.7% had increased RDW. WBC, ANC, PLT, and Ret in a high-RDW group (25.7% of SAA) were significantly higher than in a normal-RDW group (74.3% of SAA). Overall, most SAA patients exhibited normocytic–normochromic anemia, and their hemograms decreased more significantly; more than half of NSAA patients showed macrocytic-heterogeneous anemia, and their hemograms were similar to those of MDS. Patients with elevated RDW may have better residual bone marrow hematopoietic function than those with normal RDW but with more severe anemia.

Keywords:

• Aplastic anemia
• mean corpuscular volume
• red cell distribution width
• myelodysplastic syndrome
• inflammation

Author contributions

Y.L. and J.Y. designed and directed the study. L.L. and Y.L. wrote the manuscript draft. L.L., Q.F., D.Z., D.C., F.W., and R.G. collected data. X.X. and Z.J. provided resources. All authors critically reviewed and approved the final manuscript.

Disclosure statement

The authors report no conflicts of interest. The authors alone are responsible for the content and writing of this article.

Data availability statement

The datasets analyzed during the current study are not publicly available. The manuscript has not been published elsewhere and that it has not been submitted simultaneously for publication elsewhere.

Additional information

Funding

This work was supported by a grant from Science and Technology Department of Henan Province [SBGJ202102150, recipient Y.L.; LHGJ20200332, recipient D.Z.] and a grant from the National Natural Science Foundation of China [U1804192, recipient Y.L.].