Outcome prediction by interim positron emission tomography and IgM monoclonal gammopathy in diffuse large B-cell lymphoma.
Humans
Prospective Studies
Prognosis
Positron-Emission Tomography
/ methods
Lymphoma, Large B-Cell, Diffuse
/ drug therapy
Paraproteinemias
/ diagnostic imaging
Immunoglobulin M
Fluorodeoxyglucose F18
/ therapeutic use
Antineoplastic Combined Chemotherapy Protocols
/ therapeutic use
Positron Emission Tomography Computed Tomography
Diffuse large B-cell lymphoma
IgM gammopathy
Outcome prediction
Positron emission tomography
Survival
Journal
Annals of hematology
ISSN: 1432-0584
Titre abrégé: Ann Hematol
Pays: Germany
ID NLM: 9107334
Informations de publication
Date de publication:
Dec 2023
Dec 2023
Historique:
received:
12
06
2023
accepted:
28
07
2023
medline:
13
11
2023
pubmed:
11
8
2023
entrez:
11
8
2023
Statut:
ppublish
Résumé
In diffuse large B-cell lymphoma (DLBCL), a positive interim positron emission tomography (PET) scan predicts treatment failure, but the proportion of high-risk patients thus identified is small. To improve prediction, we combined the interim PET result with the presence or absence of an associated IgM gammopathy. Of 108 DLBCL patients participating in a prospective trial, nine (8%) were interim PET positive and 19 (18%) had an IgM gammopathy. The monoclonal protein was not associated with distinguishing genetic features, and its light chain restriction was not always concordant with the light chain restriction of the lymphoma. The information provided by interim PET and IgM gammopathy was combined to dichotomize the population into sizeable high-risk (1-2 adverse factors) and low-risk groups (no adverse factor) with widely different outcomes (population size, 25% vs. 75%; 3-year risk of progression, 51% vs. 10%; 3-year overall survival, 64% vs. 95%). Multivariable analyses including established risk factors revealed the interim PET result and the IgM gammopathy status to be the only factors significantly associated with outcome. Information about interim PET response and IgM gammopathy may be useful in studies testing risk-adapted treatment strategies.
Identifiants
pubmed: 37566280
doi: 10.1007/s00277-023-05393-1
pii: 10.1007/s00277-023-05393-1
pmc: PMC10640472
doi:
Substances chimiques
Immunoglobulin M
0
Fluorodeoxyglucose F18
0Z5B2CJX4D
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
3445-3455Subventions
Organisme : Deutsche Krebshilfe
ID : 107592 and 110515
Informations de copyright
© 2023. The Author(s).
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