Accuracy and prognostic impact of FDG PET/CT and biopsy in bone marrow assessment of follicular lymphoma at diagnosis: A Nation‐Wide cohort study. (13th November 2022)

• Record Type: Journal Article
• Authors: Ródenas‐Quiñonero, Isabel; Chen‐Liang, Tzu; Martín‐Santos, Taida; Salar, Antonio; Fernández‐González, Marta; Celades, Carolina; Navarro, José‐Tomás; Martínez‐Garcia, Ana Belén; Andreu, Rafael; Balaguer, Aitana; Martin García‐Sancho, Alejandro; Baile, Mónica; López‐Jiménez, Javier; Marquet‐Palomanes, Juan; Teruel, Ana Isabel; Terol, María José; Benet, Carmen; Frutos, Laura; Navarro, José Luis; Uña, Jon; Suarez, Marina; Cortes, Montserrat; Contreras, José; Ruiz, Cristina; Tamayo, Pilar; Mucientes, Jorge; Sopena‐Novales, Pablo; Reguilón‐Gallego, Laura; Sánchez‐Blanco, José Javier; Pérez‐Ceballos, Elena; Jerez, Andrés; Ortuño, Francisco José;
• Is Part Of: Cancer medicine. Volume 12:Number 6(2023)
• Page Start: 6536
• Page End: 6546
• Publication Date: 2022-11-13
• Subjects: bone marrow biopsy -- follicular lymphoma -- PET/CT; 616.994005
• DOI: 10.1002/cam4.5424
• Languages: English
• ISSNs: 2045-7634

Abstract

Abstract: Backgound: In the workup of follicular lymphoma (FL), bone marrow biopsy (BMB) assessment is a key component of FLIPI and FLIPI2, the most widely used outcome scores. During the previous decade, several studies explored the role of FDG‐PET/CT for detecting nodal and extranodal disease, with only one large study comparing both techniques. Methods: The aim of our study was to evaluate the diagnostic accuracy and the prognostic impact of both procedures in a retrospective cohort of 299 FL patients with both tests performed at diagnosis. In order to avoid a collinearity bias, FLIPI2 was deconstructed in its founding parameters, and the bone marrow involvement (BMI) parameter separately included as: a positive BMB, a positive PET/CT, the combined "PET/CT and BMB positive" or "PET/CT or BMB positive". These variables were also confronted independently with the POD24 in 233 patients treated with intensive regimens. Results: In the total cohort, bone marrow was involved in 124 and 60 patients by BMB and PET/CT, respectively. In terms of overall survival, age > 60 y.o. and the combined "PET/CT or BMB positive" achieved statistical independence as a prognostic factor. In patients treated with an intensive regimen, only the combined "PET/CT or BMB positive" added prognostic value for a shorter overall survival, when confronted with the POD24. Conclusion: Our results show that in FL both BMB and PET/CT should be considered at diagnosis, as their combined assessment provides independent prognostic value in the context of the most widely use clinical scores.