TY - JOUR
T1 - 18-Fluoro-deoxyglucose positron emission tomography report interpretation as predictor of outcome in diffuse large B-cell lymphoma including analysis of 'indeterminate' reports
AU - Thomas, Alexandra
AU - Gingrich, Roger D.
AU - Smith, Brian J.
AU - Jacobus, Laura
AU - Ristow, Kay
AU - Allmer, Cristine
AU - Maurer, Matthew J.
AU - Habermann, Thomas M.
AU - Link, Brian K.
N1 - Funding Information:
by National Institute of Health grant P50-CA97274 – Iowa/Mayo Lymphoma SPORE program.
PY - 2010/3
Y1 - 2010/3
N2 - This study evaluates the predictive value of post-therapy 18-fluoro-deoxyglucose positron emission tomography (FDG-PET), including indeterminate studies, following curative-intent therapy in diffuse large B-cell lymphoma (DLBCL). Consecutive patients from September 2002 to December 2005 were prospectively offered enrollment in an observational registry. Available FDG-PET reports after primary therapy were interpreted by hematologistoncologists as positive, negative, or indeterminate. One hundred twenty-five patients with DLBCL had a median follow-up of 35.2 months. Ninety-three percent were treated with R-CHOP-like therapy. Twenty percent of PET reports were judged indeterminate. Event-free survival (EFS) at 3 years for the negative and indeterminate groups was 85 and 71, respectively (p0.28 by log-rank). Overall survival (OS) at 3 years for negative, indeterminate, and positive groups was 89, 88, and 48. Combining the pre-therapy International Prognostic Index (IPI) with the post-therapy FDG-PET result added to the predictive value of the study for patients. Three-year EFS for patients with low or low-intermediate IPI risk and an indeterminate FDG-PET report was 93, while for those with high or high-intermediate pre-therapy IPI the 3-year EFS was 45 (p<0.02). Interpreting FDG-PET reports following curative-intent chemotherapy in patients is informative but imprecise, and incorporation of pre-therapy prognosis can improve predictive utility.
AB - This study evaluates the predictive value of post-therapy 18-fluoro-deoxyglucose positron emission tomography (FDG-PET), including indeterminate studies, following curative-intent therapy in diffuse large B-cell lymphoma (DLBCL). Consecutive patients from September 2002 to December 2005 were prospectively offered enrollment in an observational registry. Available FDG-PET reports after primary therapy were interpreted by hematologistoncologists as positive, negative, or indeterminate. One hundred twenty-five patients with DLBCL had a median follow-up of 35.2 months. Ninety-three percent were treated with R-CHOP-like therapy. Twenty percent of PET reports were judged indeterminate. Event-free survival (EFS) at 3 years for the negative and indeterminate groups was 85 and 71, respectively (p0.28 by log-rank). Overall survival (OS) at 3 years for negative, indeterminate, and positive groups was 89, 88, and 48. Combining the pre-therapy International Prognostic Index (IPI) with the post-therapy FDG-PET result added to the predictive value of the study for patients. Three-year EFS for patients with low or low-intermediate IPI risk and an indeterminate FDG-PET report was 93, while for those with high or high-intermediate pre-therapy IPI the 3-year EFS was 45 (p<0.02). Interpreting FDG-PET reports following curative-intent chemotherapy in patients is informative but imprecise, and incorporation of pre-therapy prognosis can improve predictive utility.
KW - Diffuse large B-cell lymphoma
KW - FDG-PET
KW - Prognosis
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UR - http://www.scopus.com/inward/citedby.url?scp=77249171199&partnerID=8YFLogxK
U2 - 10.3109/10428190903560198
DO - 10.3109/10428190903560198
M3 - Article
C2 - 20141442
AN - SCOPUS:77249171199
SN - 1042-8194
VL - 51
SP - 439
EP - 446
JO - Leukemia and Lymphoma
JF - Leukemia and Lymphoma
IS - 3
ER -