Interim 18-FDG-PET/CT failed to predict the outcome in diffuse large B-cell lymphoma patients treated at the diagnosis with rituximab-CHOP

Blood ◽  
2012 ◽  
Vol 119 (9) ◽  
pp. 2066-2073 ◽  
Author(s):  
Patrizia Pregno ◽  
Annalisa Chiappella ◽  
Marilena Bellò ◽  
Barbara Botto ◽  
Simone Ferrero ◽  
...  
Keyword(s):  
B Cell ◽  
Cell Lymphoma ◽  
Progression Free Survival ◽  
B Cell Lymphoma ◽  
Complete Response ◽  
Cox Models ◽  
Interim Pet ◽  
Large B Cell Lymphoma ◽  
Pet Ct ◽  
Large B Cell

Abstract Role of interim-PET (I-PET) in diffuse large B-cell Lymphoma (DLBCL) is controversial. To determine predictive value of I-PET on progression-free survival (PFS), we enrolled 88 first-line DLBCL patients treated with 6-8 R-CHOP courses regardless of I-PET. PET/CT were performed at diagnosis, after 2 to 4 courses and at the end of therapy with central reviewing according to visual dichotomous criteria. Results are as follows: I-PET, 72% negative, 28% positive; final-PET (F-PET), 88% negative, 12% positive; clinical complete response 90%. Concordance between clinical response and F-PET negativity was 97% because of 2 false positive. With a median follow-up of 26.2 months, 2-year overall survival and PFS were 91% and 77%, respectively. Two-year PFS for I-PET and F-PET negative versus positive were as follows: I-PET 85% versus 72% (P = .0475); F-PET 83% versus 64% (P < .001). Because of a small number of events, 2 independent bivariate Cox models were tested for PFS. In model 1, F-PET contradicted I-PET (hazard ratio [HR] = 5.03, P = .015 vs 1.27, P = 691); in model 2, F-PET (HR = 4.54) and International propnostic Index score (HR = 5.36, P = .001) remained independent prognostic factors. In conclusion, positive I-PET is not predictive of a worse outcome in DLBCL; larger prospective studies and harmonization of I-PET reading criteria are needed.

scholarly journals Doublet Versus Triplet PET: Is END of Therapy PET Needed IF Interim PET Is Negative in Hodgkin'S or Diffuse Large B CELL Lymphoma?

Blood ◽  
2016 ◽  
Vol 128 (22) ◽  
pp. 5354-5354
Author(s):  
Imran K Tailor ◽  
Bilal Btoosh ◽  
Shaimaa Hamdy ◽  
Shanker Raja ◽  
Mohammed O Alharbi ◽  
...  
Keyword(s):  
B Cell ◽  
Conflicts Of Interest ◽  
Cell Lymphoma ◽  
Progression Free Survival ◽  
B Cell Lymphoma ◽  
Standard Of Care ◽  
Complete Response ◽  
Interim Pet ◽  
Large B Cell Lymphoma ◽  
Large B Cell

Abstract Introduction: Baseline (PETb) and end of therapy (PETe) FDG PET is standard of care in the management of hodgkin's lymphoma (HL) and diffuse large B cell lymphoma (DLBCL). The role of interim PET (PETi) in HL is well established while its role in DLBCL is not well defined. We evaluated the utility of triPET (PETb, PETi and PETe ) in management of these two lymphomas. Methods: Retrospective review of PET archives revealed a total of 37 pts (HL=22, DLBCL=15). TriPET were acquired per accepted protocol. SUVmax and Deauville scores (DSc) were obtained from five target lesions, the average i.e. composite SUVmax & DSc were computed for each pt. Statistical analyses were performed with the composite maxSUV (cSUV) and Deauville scores (cDSc) (using EXCEL). Following statistics were performed (separately and combined in HL and DLBCL); mean+SD, PPV and NPV for complete response (CR) Vs. progressive disease (PD) on PETi using the following variables 1. cSUV and 2. cDSc and 3. delta change (DELT). Median progression free survival (PFS) was the clinical endpoint for response. Results: The mean PFS in our group was 17 and 15 months in HL and DLBCL respectively. Using cut off thresholds for intP to predict CR at cSUV<=2.0, , cDSC<=2.0 and DELT >=80%,. In HL: for cSUV- PPV 67%, NPV 95%; for DELT of cSUV PPV 100%, NPV 95%; for cDSC-PPV 30%, NPV 100%. In DLBCL: for cSUV- PPV 25%, NPV 100%; for DELT of cSUV PPV 33%, NPV 100%; for cDSC- PPV 50%, NPV 100%. Conclusion: The results from our series suggest that PETi has a role not only in HL but in DLBCL as well. Our modest cohort suggests that a negative PETi in DLBCL had a NPV of 100% across cSUV, cDSc and DELT, with regards to CR. Our data also suggests that PETe is not needed if PETi is -ve. While in HL subset, our results concur with results from other groups, this needs to be validated in a larger series. Disclosures No relevant conflicts of interest to declare.

scholarly journals Interim PET/CT based on visual and semiquantitative analysis predicts survival in patients with diffuse large B‐cell lymphoma

2019 ◽  
Vol 8 (11) ◽  
pp. 5012-5022 ◽  
Author(s):  
Xiaoqian Li ◽  
Xun Sun ◽  
Juan Li ◽  
Zijian Liu ◽  
Mi Mi ◽  
...  
Keyword(s):  
B Cell ◽  
Cell Lymphoma ◽  
B Cell Lymphoma ◽  
Semiquantitative Analysis ◽  
Interim Pet ◽  
Large B Cell Lymphoma ◽  
Pet Ct ◽  
Large B Cell

scholarly journals Bone marrow biopsy superiority over PET/CT in predicting progression-free survival in a homogeneously-treated cohort of diffuse large B-cell lymphoma

2017 ◽  
Vol 6 (11) ◽  
pp. 2507-2514 ◽  
Author(s):  
Tzu-Hua Chen-Liang ◽  
Taida Martín-Santos ◽  
Andrés Jerez ◽  
Guillermo Rodríguez-García ◽  
Leonor Senent ◽  
...  
Keyword(s):  
Bone Marrow ◽  
B Cell ◽  
Bone Marrow Biopsy ◽  
Cell Lymphoma ◽  
Progression Free Survival ◽  
B Cell Lymphoma ◽  
Free Survival ◽  
Large B Cell Lymphoma ◽  
Pet Ct ◽  
Large B Cell

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

2019 ◽  
Vol 110 (3) ◽  
pp. 331-339
Author(s):  
Renata Nyilas ◽  
Bence Farkas ◽  
Reka Rahel Bicsko ◽  
Ferenc Magyari ◽  
Laszlo Imre Pinczes ◽  
...  
Keyword(s):  
B Cell ◽  
Cell Lymphoma ◽  
B Cell Lymphoma ◽  
Good Prognosis ◽  
Interim Pet ◽  
Large B Cell Lymphoma ◽  
Pet Ct ◽  
Large B Cell

EFFICACY AND SIDE EFFECTS OF R-CHOP REGIMEN IN PATIENTS WITH DIFFUSE LARGE B-CELL CD20 POSITIVE LYMPHOMA AT HUE UNIVERSITY OF MEDICINE AND PHARMACY HOSPITAL

2018 ◽  
Vol 8 (3) ◽  
pp. 48-53 ◽  
Author(s):  
Thai Le Trong ◽  
Toan Le Duy ◽  
Khoi Tran Viet ◽  
Bao Tran Quoc ◽  
Tung Pham Tang ◽  
...  
Keyword(s):  
B Cell ◽  
Cell Lymphoma ◽  
Progression Free Survival ◽  
B Cell Lymphoma ◽  
Complete Response ◽  
Chop Regimen ◽  
Free Survival ◽  
Large B Cell Lymphoma ◽  
Large B Cell ◽  
Grade Iii

Background: Non-Hodgkin lymphomas (NHL) ranks 10 among the top 15 common cancers worldwide. Diffuse large B-cell lymphoma (DLBCL) is the most common type of the disease. Despite malignancy, DLBCL is curable and sensitive to chemotherapy and radiation therapy. Since first published in 1997, the protocol R-CHOP, a combination of classical chemotherapy CHOP with rituximab, has increased significantly the rate of complete response (CR) and improved overall survival (OS). However, there has been no report of R-CHOP treatment in Hue. Purpose of this research is to evaluate the efficiency of R-CHOP treatment (complete response, progression-free survival) and to describe the toxicities of the protocol. Methods: A retrospective cohort study on 36 patients with diffuse large B-cell lymphoma, CD 20 positive treated with R-CHOP at Hue University Hospital between 2011 and 2016. Results: According to the International prognostic index (IPI), 15 patients (41.7%) had low-risk disease, 14 (38.9%) low-to-intermediate risk, 6 (16.7%) high-to-intermediate risk and 1 (2.7%) high-risk disease. After finishing 8 cycles of therapy, 19 patients (52.8%) achieved complete response. Grade III anemia was observed (13.9%), grade III neutropeniain 4 patients (11.1%) and nausea (5.6%). During a 5-year period, progression – free survival was reported for 66.7% of patients and median for survival time was 3.3 years. Conclusions: The addition of rituximab to the CHOP regimen increases the complete-response rate and prolongs progression -free survival in patients with diffuse large-B-cell lymphoma. The treatment of R-CHOP is well tolerated that the adverse events are mostly reported at grade III and able to control effectively. Key words: diffuse large B-cell, non-hodgkin lymphoma, CD20 positive, CHOP, rituximab

Is Interim/Mid-Treatment PET (interim PET, i-PET) Scan Predictive of Outcome in Diffuse Large B-Cell Lymphoma?.

Blood ◽  
2012 ◽  
Vol 120 (21) ◽  
pp. 2675-2675
Author(s):  
Dushyant Verma ◽  
Amol Takalkar ◽  
Runhua Shi ◽  
Glenn M. Mills ◽  
Srikanth Paladugu ◽  
...  
Keyword(s):  
Overall Survival ◽  
B Cell ◽  
Cell Lymphoma ◽  
Progression Free Survival ◽  
B Cell Lymphoma ◽  
Pet Scan ◽  
Free Survival ◽  
Interim Pet ◽  
Large B Cell Lymphoma ◽  
Large B Cell

Abstract Abstract 2675 Background: Initial treatment of diffuse large B-cell lymphoma (DLBCL) involves 6–8 cycles of chemo-immunotherapy and may be curative in 60–65% of patients. However, in the remaining patients, subsequent therapies appear inadequate for long lasting remission. A strategy to improve patient outcomes could involve early identification of patients who do not respond to treatment as expected and then employing different/aggressive treatment modalities in these patients. PET scan done during mid-treatment (interim PET, i-PET) may help identify these patients early. However, the value of i-PET in DLBCL is not established as there is controversy about its prognostic value and studies are ongoing to evaluate its benefit. Aims: To determine predictive value of i-PET on progression-free survival (PFS), overall survival (OS) in DLBCL patients. Methods: We performed retrospective analysis of DLBCL patients treated at LSU Health Shreveport, LA, between Jan 2002 – July 2012. All patients were treated with R-CHOP chemotherapy. PET-CT was performed at baseline at time of diagnosis, after 2 to 4 courses (i-PET) and at the end of therapy (final PET, f-PET). Results: Forty-four patients were evaluable for analysis. The median age was 55 years (range 21–84), 32 (73%) were males. Ann-arbor staging showed 5 patients each in stage I and II, 11 patients in stage III, 23 in stage IV, and the median IPI score was 3. Median time to i-PET was after 3 cycles of chemotherapy, and median days to i-PET after chemotherapy were 16. The median follow-up duration from start of chemotherapy was 23 months (range 4 – 89). The PET results were as follows: i-PET negative 30 (68%), i-PET positive 14 (32%) patients. Final PET results were: f-PET negative 33 (75%), f-PET positive 11 (25%) patients. The 3-year PFS was 96.3% and 35.7% for i-PET negative versus positive patients respectively (p<0.001), and the 3-year PFS for f-PET negative versus positive patients was 78.9%% versus 30.0% respectively (p<0.001). The 3-year OS was 79.4% and 62.6% for i-PET negative versus positive patients respectively (p=0.3306). The 3-year OS was 79.9% and 58.7% for f-PET negative versus positive patients respectively (p=0.021). Conclusion: Interim/mid-treatment PET (i-PET) scan is predictive of progression free survival but not overall survival for DLBCL patients. A final PET (f-PET) scan is predictive of progression free survival as well as overall survival for DLBCL patients. Larger prospective studies are needed to confirm these findings and could also look into the biology of i-PET positive patients by gene expressing profiling (GEP) and evaluate the role of novel agents in modifying the disease course. Disclosures: No relevant conflicts of interest to declare.

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