Interim PET/CT in diffuse large B-cell lymphoma may facilitate identification of good-prognosis patients among IPI-stratified patients

• Published in: International journal of hematology Vol. 110; no. 3; pp. 331 - 339
• Main Authors: Nyilas, Renata, Farkas, Bence, Bicsko, Reka Rahel, Magyari, Ferenc, Pinczes, Laszlo Imre, Illes, Arpad, Gergely, Lajos
• Format: Journal Article
• Language: English
• Published: Tokyo Springer Japan 01.09.2019; Springer Nature B.V
• Subjects: Adolescent; Adult; Aged; Aged, 80 and over; Antineoplastic Combined Chemotherapy Protocols - administration & dosage; B-cell lymphoma; Computed tomography; Cyclophosphamide - administration & dosage; Disease-Free Survival; Doxorubicin - administration & dosage; Female; Follow-Up Studies; Hematology; Humans; Lymphocytes B; Lymphoma; Lymphoma, Large B-Cell, Diffuse - diagnostic imaging; Lymphoma, Large B-Cell, Diffuse - drug therapy; Lymphoma, Large B-Cell, Diffuse - mortality; Male; Medical prognosis; Medicine; Medicine & Public Health; Middle Aged; Oncology; Original Article; Positron Emission Tomography Computed Tomography; Prednisone - administration & dosage; Prognosis; Retrospective Studies; Risk groups; Rituximab - administration & dosage; Statistical analysis; Survival Rate; Vincristine - administration & dosage; Response; Interim PET/CT; DLBCL; PET/CT; Diffuse large B-cell lymphoma
• ISSN: 0925-5710; 1865-3774
• DOI: 10.1007/s12185-019-02690-2

Treating patients with DLBCL remains a challenge, as the response to first-line immunochemotherapy is somewhat unpredictable. The International Prognostic Index (IPI) is one of the most widely used methods for assessing prognosis. Interim PET/CT (iPET/CT) can play an important role in the early identification of ‘non-responder’ patients before the end of treatment examination. In this study, we retrospectively analyzed 104 newly diagnosed DLBCL patients treated with R-CHOP-like regimens who underwent iPET/CT imaging during therapy. There was a significant difference in 2-year OS between patients with negative iPET/CT and those with positive iPET/CT. Patients who had positive iPET/CT showed inferior 2-year PFS compared to those with negative iPET/CT. According to IPI, there was a statistically significant difference in 2-year OS and PFS between patients in the lower and higher risk groups. However, these patients can be further subdivided according to iPET/CT. The iPET/CT results in the present study clearly separate good- and poor-prognosis patients according to differences in 2-year OS, both in the lower and higher IPI risk groups. These results are in agreement with those of previous studies that demonstrated that iPET/CT has high negative predictive value, clearly identifying good-prognosis patients even within the poor-prognosis IPI group.