Detection of extranodal and spleen involvement by FDG-PET imaging predicts adverse survival in untreated follicular lymphoma.


Journal

American journal of hematology
ISSN: 1096-8652
Titre abrégé: Am J Hematol
Pays: United States
ID NLM: 7610369

Informations de publication

Date de publication:
07 2019
Historique:
received: 05 04 2019
revised: 09 04 2019
accepted: 16 04 2019
pubmed: 23 4 2019
medline: 11 3 2020
entrez: 23 4 2019
Statut: ppublish

Résumé

Predicting early clinical failure in patients with untreated follicular lymphoma (FL) is important but difficult. This study aimed to determine the incidence and patterns of extranodal (EN) and spleen disease using PET/CT, and assess their utility in predicting early clinical failure. PET/CT images from 613 cases of untreated FL (2003-2016) were reviewed. The location and number of EN sites, patterns of bone involvement, and splenic involvement were recorded. Outcomes were assessed using event-free survival (EFS), overall survival (OS), and early clinical failure at 24 months (EFS24). So, 49% (301/613) of patients had PET/CT-detected EN involvement, and 28% (171/613) had spleen involvement. The presence of ≥2 EN sites, spleen, bone or soft tissue involvement all predicted failure to achieve EFS24. Presence of ≥2 EN sites and bone involvement pattern were also predictive of OS in a univariate analysis. In a multivariate analysis with FLIPI-2 factors, spleen involvement, pattern of bone involvement, and soft tissue involvement independently predicted a lower EFS (HR 1.49 (1.11-2.00), P = .007; HR 1.71 (1.10-2.65), P = .017; and HR 1.67 (1.06-2.62), P = .026, respectively). When the multivariate analysis was performed using PRIMA-PI factors (marrow and B2M), the number of EN sites was an independent prognostic factor for inferior OS (HR 2.28; P = .05). Baseline PET/CT identifies EN involvement in nearly half of patients with untreated FL. The presence of ≥2 EN sites, bone, soft tissue, or splenic involvement predicts early clinical failure. These results, when combined with other factors, may better identify high-risk patients and guide therapy.

Identifiants

pubmed: 31006875
doi: 10.1002/ajh.25493
doi:

Substances chimiques

Fluorodeoxyglucose F18 0Z5B2CJX4D

Types de publication

Clinical Trial Journal Article Research Support, Non-U.S. Gov't

Langues

eng

Sous-ensembles de citation

IM

Pagination

786-793

Subventions

Organisme : Mayo Clinic
Pays : International

Informations de copyright

© 2019 Wiley Periodicals, Inc.

Auteurs

Frédérique St-Pierre (F)

Department of Medicine, Mayo Clinic, Rochester, Minnesota.

Stephen M Broski (SM)

Department of Radiology, Division of Nuclear Radiology, Mayo Clinic, Rochester, Minnesota.

Betsy R LaPlant (BR)

Department of Health Sciences Research, Division of Biomedical Statistics and Informatics, Mayo Clinic, Rochester, Minnesota.

Kay Ristow (K)

Department of Medicine, Division of Hematology, Mayo Clinic, Rochester, Minnesota.

Matthew J Maurer (MJ)

Department of Health Sciences Research, Division of Biomedical Statistics and Informatics, Mayo Clinic, Rochester, Minnesota.

William R Macon (WR)

Department of Laboratory Medicine, Mayo Clinic, Rochester, Minnesota.

Thomas M Habermann (TM)

Department of Medicine, Division of Hematology, Mayo Clinic, Rochester, Minnesota.

Stephen M Ansell (SM)

Department of Medicine, Division of Hematology, Mayo Clinic, Rochester, Minnesota.

Carrie A Thompson (CA)

Department of Medicine, Division of Hematology, Mayo Clinic, Rochester, Minnesota.

Ivana N M Micallef (INM)

Department of Medicine, Division of Hematology, Mayo Clinic, Rochester, Minnesota.

Grzegorz S Nowakowski (GS)

Department of Medicine, Division of Hematology, Mayo Clinic, Rochester, Minnesota.

Thomas E Witzig (TE)

Department of Medicine, Division of Hematology, Mayo Clinic, Rochester, Minnesota.

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