The impact of baseline and interim PET/CT parameters on clinical outcome in patients with diffuse large B cell lymphoma

• Published in: American journal of hematology 2012-09, Vol.87 (9), p.937-940
• Main Authors: Park, Silvia, Moon, Seung Hwan, Park, Lee Chun, Hwang, Deok Won, Ji, Jun Ho, Maeng, Chi Hoon, Cho, Su-Hee, Ahn, Hee Kyung, Lee, Ji Yean, Kim, Seok Jin, Choi, Joon Young, Kim, Won Seog
• Format: Article
• Language: English
• Subjects: Antineoplastic Combined Chemotherapy Protocols - administration & dosage; Antineoplastic Combined Chemotherapy Protocols - therapeutic use; Biological and medical sciences; Clinical outcomes; Cyclophosphamide - administration & dosage; Cyclophosphamide - therapeutic use; Disease-Free Survival; Doxorubicin - administration & dosage; Doxorubicin - therapeutic use; Drug Administration Schedule; Female; Fluorodeoxyglucose F18 - economics; Hematologic and hematopoietic diseases; Hematology; Humans; Leukemias. Malignant lymphomas. Malignant reticulosis. Myelofibrosis; Lymphoma, Large B-Cell, Diffuse - diagnostic imaging; Lymphoma, Large B-Cell, Diffuse - drug therapy; Lymphoma, Large B-Cell, Diffuse - mortality; Male; Medical sciences; Multimodal Imaging; Neoplasm Staging; Positron-Emission Tomography; Predictive Value of Tests; Prednisone - administration & dosage; Prednisone - therapeutic use; Prognosis; Risk; Tomography, X-Ray Computed; Treatment Outcome; Vincristine - administration & dosage; Vincristine - therapeutic use
• ISSN: 0361-8609; 1096-8652
• DOI: 10.1002/ajh.23267

Taking a step forward from the IPI, attention is focused on the role of 18F-FDG PET/CT as a tool for guidance in risk stratification in patients with aggressive non-Hodgkin's lymphoma (NHL). Here, we analyzed the predictive value of various PET/CT parameters in patients with DLBCL. Particularly, we were interested in patients with an IPI score of 1, 2, or 3, whose prognosis are confusing. Between Jul 2008 and Feb 2010, a total of 100 patients (including 57 patients with an IPI score of 1-3) who were treated with R-CHOP for DLBCL, and had assessable PET/CT parameters were analyzed in this study. Absolute value of SUVmax, SUVsum(sum of SUVmax) and TLGsum(SUVmean x Volumemeta) from baseline and interim PET/CT, and ΔSUVsum, ΔSUVmax, and ΔTLGsum between baseline and interim PET/CT were selected as PET/CT parameters. The median number of R-CHOP cycles was 6, and interim PET/CT was performed after 2 or 3 cycles. None of the parameters which showed percentile change between initial and interim PET/CT were associated with prognosis. Instead, absolute value of SUVsum from baseline PET/CT, and SUVmax and SUVsum from interim PET/CT were significantly relevant to PFS in all patients, and in patients with an IPI score of 1–3.