Interim 18F-FDG PET/CT and BCL2 for predicting the prognosis of patients with diffuse large B-cell lymphoma in the rituximab era. Issue 2 (February 2018)

• Record Type: Journal Article
• Authors: Jiang, Maoqing; Chen, Ping; Ruan, Xinzhong; Xu, Weiling; Li, Tianfu; Wu, Liyun; Zhou, Wenlan; Wu, Hubing; Wang, Quanshi
• Is Part Of: Nuclear medicine communications. Volume 39:Issue 2(2018:Feb.)
• Publication Date: 2018-02
• Subjects: BCL2 -- chemotherapy -- diffuse large B-cell lymphoma -- interim PET/CT; Nuclear medicine -- Periodicals; 616.07575
• DOI: 10.1097/MNM.0000000000000784
• Languages: English
• ISSNs: 0143-3636

Abstract

Abstract : Objective: In this study, we investigated the prognostic role of interim fluorine-18-fluorodeoxyglucose PET/computed tomography (I-PET/CT) and BCL2 in diffuse large B-cell lymphoma (DLBCL) patients treated with rituximab-containing chemotherapy. Materials and methods: A total of 106 patients with newly diagnosed DLBCL underwent PET/CT scans at baseline and a subsequent I-PET/CT after the fourth cycle of chemotherapy. I-PET/CT was analyzed using the Deauville five-point score. The prognostic significance of I-PET/CT and BCL2 was evaluated by predicting progression-free survival (PFS) and overall survival (OS). Results: With a median follow-up of 25 months, the 2-year PFS and OS were 78 and 95% in the I-PET/CT-negative group and 33 and 57% in the I-PET/CT-positive group ( P <0.001). Patients with BCL2 positivity showed a shorter PFS than the BCL2-negative patients ( P =0.002), but not in OS ( P =0.068). In multivariate analysis, I-PET/CT and BCL2 were independent variables in assessing the outcome of PFS. I-PET/CT was also an independent factor for OS. Irrespective of the results of BCL2, patients with I-PET/CT positivity had a significant inferior outcome than the I-PET/CT-negative patients. In the I-PET/CT-negative group, patients with BCL2 positivity had a significantly shorter PFS than the BCL2-negative patients ( P =0.005). Conclusion: I-PET/CT and BCL2 were two significant independent indicators of outcome for patients with DLBCL in the rituximab era. I-PET/CT was much better than BCL2 for patient stratification. BCL2 showed its supplementary role for further patient stratification when I-PET/CT was negative.