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Title: [Prognostic significance of (18)F-fluorodeoxyglucose positron emission tomography in patients with diffuse large B cell lymphoma undergoing autologous stem cell transplantation].
Author: Ying ZT, Mi L, Wang XJ, Zhang YW, Yang Z, Song YQ, Wang XP, Zheng W, Lin NJ, Tu MF, Xie Y, Ping LY, Zhang C, Liu WP, Deng LJ, Zhu J.
Journal: Zhonghua Xue Ye Xue Za Zhi; 2018 May 14; 39(5):382-386. PubMed ID: 29779346.
Abstract:
Objective: To evaluate the prognostic value of (18)F-fluorodeoxyglucose positron emission tomography (PET)/computed tomography (CT) in patients with diffuse large B cell lymphoma (DLBCL) undergoing autologous hematopoietic stem cell transplantation (auto-HSCT). Methods: Forty-eight patients with DLBCL treated at Peking University Cancer Hospital between November 2010 and December 2014 were assessed. All patients underwent PET/CT scanning prior to or after auto-HSCT. Correlation analysis was done based upon patients characteristics, PET/CT scan results and survival. Results: ①Among 48 patients, 27 was male, 21 female, median age was 43 (17-59) years old. ② Patients with negative pre-auto-HSCT PET/CT assessment demonstrated significantly better 3-year progression free survival (PFS) (87.1% vs 53.3%, χ(2)=7.02, P=0.019) and overall survival (OS) (90.3% vs 60.0%, χ(2)=6.51,P=0.022) than patients with positive pre-auto-HSCT PET/CT assessment. Three-year PFS (94.1% vs 30.0%, χ(2)=22.75, P=0.001) and OS (97.1% vs 40.0%, χ(2)=21.09, P=0.002) were also significantly different between patients with negative and positive post-auto-HSCT PET/CT assessment. ③ Multivariate analysis indicated a significant association of PFS (HR=13.176, P=0.005) and OS (HR=20.221, P=0.007) with post-auto-HSCT PET/CT assessment. Number of prior treatment regimens was associated with PFS (HR=10.039, P=0.040). ④ Harrell's C index revealed that the value of combined use of number of prior treatment regimens and post-auto-HSCT PET/CT assessment was superior to either one used alone in PFS (Harrell's C values were 0.976, 0.869 and 0.927 in combined use, number of prior treatment regimens and post-auto-HSCT PET/CT assessment, respectively), and the combined use of ECOG performance status and post-auto-HSCT PET/CT assessment significantly increased the Harrell's C index in OS (Harrell's C values were 0.973, 0.711 and 0.919 in combined use, ECOG performance status and post-auto-HSCT PET/CT assessment, respectively). Conclusions: Post-auto-HSCT PET/CT assessment is the main predictor of outcomes in DLBCL patients receiving auto-HSCT. Combined use of post-auto-HSCT PET/CT assessment and number of prior treatment regimens and ECOG performance status is a better prognostic tool in patients with DLBCL undergoing transplantation. 目的： 探讨(18)F-FDG PET-CT评估在接受auto-HSCT的弥漫大B细胞淋巴瘤（DLBCL）患者中的预后价值。 方法： 回顾性分析2010年11月至2014年12月在北京大学肿瘤医院接受auto-HSCT的48例DLBCL患者资料，所有患者移植前或者移植后行PET-CT检查，结合患者基本临床特征及生存进行相关性分析。 结果： ①48例患者中，男27例，女21例，中位年龄为43（17~59）岁。②移植前PET-CT评估阴性和阳性患者的3年无进展生存（PFS）率分别为87.1%和53.3%（χ(2)=7.02，P=0.019），3年总生存（OS）率分别为90.3%和60.0%（χ(2)=6.51，P=0.022）；移植后两组患者的3年PFS率分别为94.1%和30.0%（χ(2)=22.75，P=0.001），3年OS率分别为97.1%和40.0%（χ(2)=21.09，P=0.002）。③多因素分析结果显示，移植后PET-CT评估阳性是影响患者PFS（HR=13.176，P=0.005）和OS（HR=20.221，P=0.007）的预后不良因素；移植前治疗方案数与PFS相关（HR=10.039，P=0.040）。④Harrell’s C值显示移植后PET-CT评估与移植前治疗方案数联合使用预测PFS的价值优于单独使用（联合使用、移植前治疗方案数、移植后PET-CT评估的Harrell’s C值分别为0.976、0.869、0.927）；移植后PET-CT与ECOG体力状态评分联合使用能更好预测OS（联合使用、ECOG体力状态评分、移植后PET-CT评估的Harrell’s C值分别为0.973、0.711、0.919）。 结论： 移植后PET-CT评估在接受auto-HSCT的DLBCL患者中有重要预后作用，移植后PET-CT评估联合移植前治疗方案数以及ECOG体力状态评分可能能够更好地预测患者预后。.

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