TY - JOUR
T1 - Interim 18-FDG-PET/CT failed to predict the outcome in diffuse large B-cell lymphoma patients treated at the diagnosis with rituximab-CHOP
AU - Pregno, Patrizia
AU - Chiappella, Annalisa
AU - Bellò, Marilena
AU - Botto, Barbara
AU - Ferrero, Simone
AU - Franceschetti, Silvia
AU - Giunta, Francesca
AU - Ladetto, Marco
AU - Limerutti, Giorgio
AU - Menga, Massimo
AU - Nicolosi, Maura
AU - Priolo, Giorgio
AU - Puccini, Benedetta
AU - Rigacci, Luigi
AU - Salvi, Flavia
AU - Vaggelli, Luca
AU - Passera, Roberto
AU - Bisi, Gianni
AU - Vitolo, Umberto
PY - 2012/3/1
Y1 - 2012/3/1
N2 - Role of interim-PET (I-PET) in diffuse large B-cell Lymphoma (DLBCL) is controversial. To determine predictive value of I-PET on progression-free survival (PFS), we enrolled 88 first-line DLBCL patients treated with 6-8 R-CHOP courses regardless of I-PET. PET/CT were performed at diagnosis, after 2 to 4 courses and at the end of therapy with central reviewing according to visual dichotomous criteria. Results are as follows: I-PET, 72% negative, 28% positive; final-PET (F-PET), 88% negative, 12% positive; clinical complete response 90%. Concordance between clinical response and F-PET negativity was 97% because of 2 false positive.With a median follow-up of 26.2 months, 2-year overall survival and PFS were 91% and 77%, respectively. Two-year PFS for I-PET and F-PET negative versus positive were as follows: I-PET 85% versus 72% (P ∇ .0475); F-PET 83% versus 64% (P < .001). Because of a small number of events, 2 independent bivariate Cox models were tested for PFS. In model 1, F-PET contradicted I-PET (hazard ratio [HR] ∇ 5.03, P ∇ .015 vs 1.27, P ∇ 691); in model 2, F-PET (HR ∇ 4.54) and International propnostic Index score (HR ∇ 5.36, P ∇ .001) remained independent prognostic factors. In conclusion, positive I-PET is not predictive of a worse outcome in DLBCL; larger prospective studies and harmonization of I-PET reading criteria are needed.
AB - Role of interim-PET (I-PET) in diffuse large B-cell Lymphoma (DLBCL) is controversial. To determine predictive value of I-PET on progression-free survival (PFS), we enrolled 88 first-line DLBCL patients treated with 6-8 R-CHOP courses regardless of I-PET. PET/CT were performed at diagnosis, after 2 to 4 courses and at the end of therapy with central reviewing according to visual dichotomous criteria. Results are as follows: I-PET, 72% negative, 28% positive; final-PET (F-PET), 88% negative, 12% positive; clinical complete response 90%. Concordance between clinical response and F-PET negativity was 97% because of 2 false positive.With a median follow-up of 26.2 months, 2-year overall survival and PFS were 91% and 77%, respectively. Two-year PFS for I-PET and F-PET negative versus positive were as follows: I-PET 85% versus 72% (P ∇ .0475); F-PET 83% versus 64% (P < .001). Because of a small number of events, 2 independent bivariate Cox models were tested for PFS. In model 1, F-PET contradicted I-PET (hazard ratio [HR] ∇ 5.03, P ∇ .015 vs 1.27, P ∇ 691); in model 2, F-PET (HR ∇ 4.54) and International propnostic Index score (HR ∇ 5.36, P ∇ .001) remained independent prognostic factors. In conclusion, positive I-PET is not predictive of a worse outcome in DLBCL; larger prospective studies and harmonization of I-PET reading criteria are needed.
UR - http://www.scopus.com/inward/record.url?scp=84857754802&partnerID=8YFLogxK
U2 - 10.1182/blood-2011-06-359943
DO - 10.1182/blood-2011-06-359943
M3 - Article
SN - 0006-4971
VL - 119
SP - 2066
EP - 2073
JO - Blood
JF - Blood
IS - 9
ER -