Maurizio Martelli1, Luca Ceriani1, Emanuele Zucca2, Pier Luigi Zinzani1, Andrés J M Ferreri1, Umberto Vitolo1, Caterina Stelitano1, Ercole Brusamolino1, Maria Giuseppina Cabras1, Luigi Rigacci1, Monica Balzarotti1, Flavia Salvi1, Silvia Montoto1, Armando Lopez-Guillermo1, Erica Finolezzi1, Stefano A Pileri1, Andrew Davies1, Franco Cavalli1, Luca Giovanella1, Peter W M Johnson1. 1. Maurizio Martelli and Erica Finolezzi, Sapienza University, Rome; Pier Luigi Zinzani and Stefano A. Pileri, Policlinico S. Orsola-Malpighi, Bologna; Andrés J.M. Ferreri, San Raffaele Scientific Institute, Milan; Umberto Vitolo, Azienda Ospedaliera S. Giovanni Battista, Torino; Caterina Stelitano, Azienda Ospedaliera Bianchi-Melacrino-Morelli, Reggio Calabria; Ercole Brusamolino, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) Policlinico San Matteo, Pavia; Maria Giuseppina Cabras, Ospedale Businco, Cagliari; Luigi Rigacci, Policlinico Careggi, Florence; Monica Balzarotti, IRCCS Humanitas, Rozzano; Flavia Salvi, Azienda Ospedaliera SS. Antonio e Biagio e Cesare Arrigo, Alessandria, Italy; Luca Ceriani, Emanuele Zucca, Franco Cavalli, and Luca Giovanella, Oncology Institute of Southern Switzerland, Bellinzona, Switzerland; Silvia Montoto, Barts Cancer Institute, London; Andrew Davies and Peter W.M. Johnson, University of Southampton, Southampton, United Kingdom; and Armando Lopez-Guillermo, Hospital Clinic, Barcelona, Spain. 2. Maurizio Martelli and Erica Finolezzi, Sapienza University, Rome; Pier Luigi Zinzani and Stefano A. Pileri, Policlinico S. Orsola-Malpighi, Bologna; Andrés J.M. Ferreri, San Raffaele Scientific Institute, Milan; Umberto Vitolo, Azienda Ospedaliera S. Giovanni Battista, Torino; Caterina Stelitano, Azienda Ospedaliera Bianchi-Melacrino-Morelli, Reggio Calabria; Ercole Brusamolino, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) Policlinico San Matteo, Pavia; Maria Giuseppina Cabras, Ospedale Businco, Cagliari; Luigi Rigacci, Policlinico Careggi, Florence; Monica Balzarotti, IRCCS Humanitas, Rozzano; Flavia Salvi, Azienda Ospedaliera SS. Antonio e Biagio e Cesare Arrigo, Alessandria, Italy; Luca Ceriani, Emanuele Zucca, Franco Cavalli, and Luca Giovanella, Oncology Institute of Southern Switzerland, Bellinzona, Switzerland; Silvia Montoto, Barts Cancer Institute, London; Andrew Davies and Peter W.M. Johnson, University of Southampton, Southampton, United Kingdom; and Armando Lopez-Guillermo, Hospital Clinic, Barcelona, Spain. ielsg@ticino.com.
Abstract
PURPOSE: To assess the role of [18F]fluorodeoxyglucose ([18F]FDG) positron emission tomography/computed tomography (PET/CT) after rituximab and anthracycline-containing chemoimmunotherapy in patients with primary mediastinal large B-cell lymphoma (PMLBCL). PATIENTS AND METHODS: Among 125 patients prospectively enrolled, 115 were eligible for central review of PET/CT scans at the completion of standard chemoimmunotherapy, by using a five-point scale. Consolidation radiotherapy (RT) was permitted and given to 102 patients. RESULTS: Fifty-four patients (47%) achieved a complete metabolic response (CMR), defined as a completely negative scan or with residual [18F]FDG activity below the mediastinal blood pool (MBP) uptake. In the remaining 61 patients (53%), the residual uptake was higher than MBP uptake but below the liver uptake in 27 (23%), slightly higher than the liver uptake in 24 (21%), and markedly higher in 10 (9%). CMR after chemoimmunotherapy predicted higher 5-year progression-free survival (PFS; 98% v 82%; P=.0044) and overall survival (OS; 100% v 91%; P=.0298). Patients with residual uptake higher than MBP uptake but below liver uptake had equally good outcomes without any recurrence. Using the liver uptake as cutoff for PET positivity (boundary of score, 3 to 4) discriminated most effectively between high or low risk of failure, with 5-year PFS of 99% versus 68% (P<.001) and 5-year OS of 100% versus 83% (P<.001). CONCLUSION: More than 90% of patients are projected to be alive and progression-free at 5 years, despite a low CMR rate (47%) after chemoimmunotherapy. This study provides a basis for using PET/CT to define the role of RT in PMLBCL.
PURPOSE: To assess the role of [18F]fluorodeoxyglucose ([18F]FDG) positron emission tomography/computed tomography (PET/CT) after rituximab and anthracycline-containing chemoimmunotherapy in patients with primary mediastinal large B-cell lymphoma (PMLBCL). PATIENTS AND METHODS: Among 125 patients prospectively enrolled, 115 were eligible for central review of PET/CT scans at the completion of standard chemoimmunotherapy, by using a five-point scale. Consolidation radiotherapy (RT) was permitted and given to 102 patients. RESULTS: Fifty-four patients (47%) achieved a complete metabolic response (CMR), defined as a completely negative scan or with residual [18F]FDG activity below the mediastinal blood pool (MBP) uptake. In the remaining 61 patients (53%), the residual uptake was higher than MBP uptake but below the liver uptake in 27 (23%), slightly higher than the liver uptake in 24 (21%), and markedly higher in 10 (9%). CMR after chemoimmunotherapy predicted higher 5-year progression-free survival (PFS; 98% v 82%; P=.0044) and overall survival (OS; 100% v 91%; P=.0298). Patients with residual uptake higher than MBP uptake but below liver uptake had equally good outcomes without any recurrence. Using the liver uptake as cutoff for PET positivity (boundary of score, 3 to 4) discriminated most effectively between high or low risk of failure, with 5-year PFS of 99% versus 68% (P<.001) and 5-year OS of 100% versus 83% (P<.001). CONCLUSION: More than 90% of patients are projected to be alive and progression-free at 5 years, despite a low CMR rate (47%) after chemoimmunotherapy. This study provides a basis for using PET/CT to define the role of RT in PMLBCL.
Authors: Vitaliana DE Sanctis; Alice DI Rocco; Maria Christina Cox; Maurizio Valeriani; Francesca Perrone Congedi; Dimitri Anzellini; Maria Massaro; Gianluca Vullo; Giuseppe Facondo; Flavia DE Giacomo; Marco Alfò; Daniela Prosperi; Patrizia Pizzichini; Sabrina Pelliccia; Agostino Tafuri; Maurizio Martelli; Mattia Falchetto Osti Journal: In Vivo Date: 2020 May-Jun Impact factor: 2.155
Authors: T P Vassilakopoulos; G A Pangalis; S Chatziioannou; S Papageorgiou; M K Angelopoulou; Z Galani; G Kourti; V Prassopoulos; T Leonidopoulou; E Terpos; M N Dimopoulou; S Sachanas; C Kalpadakis; P Konstantinidou; D Boutsis; E Stefanoudaki; L Kyriazopoulou; M P Siakantaris; M-C Kyrtsonis; E Variami; I Kotsianidis; A Symeonidis; E Michali; E Katodritou; G Kokkini; C Tsatalas; H Papadaki; M-A Dimopoulos; V Sotiropoulos; V Pappa; T Karmiris; J Meletis; J Apostolidis; I Datseris; P Panayiotidis; K Konstantopoulos; P Roussou; P Rondogianni Journal: Leukemia Date: 2015-05-14 Impact factor: 11.528
Authors: Santosha Vardhana; Paul A Hamlin; Joanna Yang; Andrew Zelenetz; Craig S Sauter; Matthew J Matasar; Andy Ni; Joachim Yahalom; Craig H Moskowitz Journal: Biol Blood Marrow Transplant Date: 2018-06-15 Impact factor: 5.742