Prognostic Value of Bone Marrow F-18 FDG Uptake in Patients with Advanced-Stage Diffuse Large B-Cell Lymphoma

• Published in: Nuclear medicine and molecular imaging Vol. 54; no. 1; pp. 28 - 34
• Main Authors: Wang, Jiyoung, Kim, Dongwoo, Kang, Won Jun, Cho, Hojin
• Format: Journal Article
• Language: English
• Published: Singapore Springer Singapore 01.02.2020; Springer Nature B.V; 대한핵의학회
• Subjects: Bone marrow; Cardiology; Computed tomography; Fluorine isotopes; Hazard assessment; Imaging; Lymphoma; Medicine; Medicine & Public Health; Nuclear Medicine; Oncology; Original; Original Article; Orthopedics; Positron emission; Radioisotopes; Radiology; Statistical models; Survival; Tomography; 방사선과학; Fluorodeoxyglucose; Bone marrow involvement; Prognosis; Diffuse large B-cell lymphoma
• ISSN: 1869-3474; 1869-3482
• DOI: 10.1007/s13139-019-00630-w

Purpose We assessed prognostic implication of bone marrow uptake on baseline F-18 fluorodeoxyglucose positron emission tomography/computed tomography (FDG PET/CT) in patients with advanced-stage diffuse large B-cell lymphoma (DLBCL). Methods We retrospectively reviewed 140 patients with stage III and IV DLBCL, who underwent baseline F-18 FDG PET/CT at diagnosis. Bone marrow uptake on F-18 FDG PET/CT (BM FDG) was compared with findings on bone marrow biopsy (BMB), and patients were grouped based on these results: BMB-positive and BM FDG-positive (group 1), BMB-positive and BM FDG-negative (group 2), BMB-negative and BM FDG-positive (group 3), and BMB-negative and BM FDG-negative (group 4). The prognostic value of clinicopathologic factors and BM FDG for predicting progression-free survival (PFS) and overall survival (OS) was assessed using a Cox proportional hazards model. Differences in PFS and OS were examined by the Kaplan-Meier method. Results BMB was the only significant indicator in predicting PFS, and age, IPI score higher than 3, and BM FDG significantly predicted OS. Group 1 showed inferior PFS than group 2 (median PFS, 7.4 vs. 13.9 months; p  = 0.04). In contrast, there was no significant difference either in PFS or OS between group 2 and group 3. Conclusion We showed that BM FDG-positive predicted a poorer survival in patients with advanced stage DBLCL. We also found that BMB-negative and BM FDG-positive patients had similar PFS or OS to BMB-positive and BM FDG-negative patients. Further study in a larger population is needed to clarify clinical significance of BM FDG in these patients.