A S Cottereau1, S Becker2, F Broussais3, O Casasnovas4, S Kanoun5, M Roques4, N Charrier6, S Bertrand6, R Delarue7, C Bonnet8, R Hustinx9, P Gaulard10, L de Leval11, P Vera12, E Itti13, N Mounier14, C Haioun15, H Tilly16, M Meignan17. 1. Department of Nuclear Medicine, Centre H. Becquerel and Rouen University Hospital, Rouen Department of Hematology, Centre H. Becquerel, Rouen, France. 2. Department of Nuclear Medicine, Centre H. Becquerel and Rouen University Hospital, Rouen. 3. Department of Hematology, Institut Paoli-Calmettes, Marseille. 4. Department of Hematology, Hopital Le Bocage, C.H.U Dijon. 5. Department of Nuclear Medicine, Centre GF Leclerc, Dijon. 6. Department of Nuclear Medicine, Institut Paoli-Calmettes, Marseille. 7. Department of Hematology, Hopital Necker, Paris, France. 8. Departments of Hematology. 9. Nuclear Medicine, C.H.U, ULg, Liège, Belgium. 10. Department of Pathology, Groupe Henri Mondor-Albert Chenevier, Créteil Faculte de Medecine, Université Paris-Est, Créteil Unité U955, INSERM, Creteil, France. 11. Institute of Pathology, Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland. 12. Department of Nuclear Medicine, Centre H. Becquerel and Rouen University Hospital, Rouen QuantIF (Litis EA 418) University of Rouen, Rouen. 13. Department of Nuclear Medicine, Groupe Henri Mondor-Albert Chenevier, Créteil. 14. Department of Hematology, Groupe hospitalier l'Archet, Nice. 15. Faculte de Medecine, Université Paris-Est, Créteil Unité U955, INSERM, Creteil, France Lymphoid Malignancies Unit, Department of Hematology, Groupe Henri Mondor-Albert Chenevier, Créteil. 16. Department of Hematology, Centre H. Becquerel, Rouen, France. 17. Department of Nuclear Medicine, Groupe Henri Mondor-Albert Chenevier, Créteil michel.meignan@hmn.aphp.fr.
Abstract
BACKGROUND: Most peripheral T-cell lymphoma (PTCL) patients have a poor outcome and the identification of prognostic factors at diagnosis is needed. PATIENTS AND METHODS: The prognostic impact of total metabolic tumor volume (TMTV0), measured on baseline [(18)F]2-fluoro-2-deoxy-d-glucose positron emission tomography/computed tomography, was evaluated in a retrospective study including 108 PTCL patients (27 PTCL not otherwise specified, 43 angioimmunoblastic T-cell lymphomas and 38 anaplastic large-cell lymphomas). All received anthracycline-based chemotherapy. TMTV0 was computed with the 41% maximum standardized uptake value threshold method and an optimal cut-off point for binary outcomes was determined and compared with others prognostic factors. RESULTS: With a median follow-up of 23 months, 2-year progression-free survival (PFS) was 49% and 2-year overall survival (OS) was 67%. High TMTV0 was significantly associated with a worse prognosis. At 2 years, PFS was 26% in patients with a high TMTV0 (>230 cm(3), n = 53) versus 71% for those with a low TMTV0, [P < 0.0001, hazard ratio (HR) = 4], whereas OS was 50% versus 80%, respectively, (P = 0.0005, HR = 3.1). In multivariate analysis, TMTV0 was the only significant independent parameter for both PFS and OS. TMTV0, combined with PIT, discriminated even better than TMTV0 alone, patients with an adverse outcome (TMTV0 >230 cm(3) and PIT >1, n = 33,) from those with good prognosis (TMTV0 ≤230 cm(3) and PIT ≤1, n = 40): 19% versus 73% 2-year PFS (P < 0.0001) and 43% versus 81% 2-year OS, respectively (P = 0.0002). Thirty-one patients (other TMTV0-PIT combinations) had an intermediate outcome, 50% 2-year PFS and 68% 2-year OS. CONCLUSION: TMTV0 appears as an independent predictor of PTCL outcome. Combined with PIT, it could identify different risk categories at diagnosis and warrants further validation as a prognostic marker.
BACKGROUND: Most peripheral T-cell lymphoma (PTCL) patients have a poor outcome and the identification of prognostic factors at diagnosis is needed. PATIENTS AND METHODS: The prognostic impact of total metabolic tumor volume (TMTV0), measured on baseline [(18)F]2-fluoro-2-deoxy-d-glucose positron emission tomography/computed tomography, was evaluated in a retrospective study including 108 PTCL patients (27 PTCL not otherwise specified, 43 angioimmunoblastic T-cell lymphomas and 38 anaplastic large-cell lymphomas). All received anthracycline-based chemotherapy. TMTV0 was computed with the 41% maximum standardized uptake value threshold method and an optimal cut-off point for binary outcomes was determined and compared with others prognostic factors. RESULTS: With a median follow-up of 23 months, 2-year progression-free survival (PFS) was 49% and 2-year overall survival (OS) was 67%. High TMTV0 was significantly associated with a worse prognosis. At 2 years, PFS was 26% in patients with a high TMTV0 (>230 cm(3), n = 53) versus 71% for those with a low TMTV0, [P < 0.0001, hazard ratio (HR) = 4], whereas OS was 50% versus 80%, respectively, (P = 0.0005, HR = 3.1). In multivariate analysis, TMTV0 was the only significant independent parameter for both PFS and OS. TMTV0, combined with PIT, discriminated even better than TMTV0 alone, patients with an adverse outcome (TMTV0 >230 cm(3) and PIT >1, n = 33,) from those with good prognosis (TMTV0 ≤230 cm(3) and PIT ≤1, n = 40): 19% versus 73% 2-year PFS (P < 0.0001) and 43% versus 81% 2-year OS, respectively (P = 0.0002). Thirty-one patients (other TMTV0-PIT combinations) had an intermediate outcome, 50% 2-year PFS and 68% 2-year OS. CONCLUSION: TMTV0 appears as an independent predictor of PTCL outcome. Combined with PIT, it could identify different risk categories at diagnosis and warrants further validation as a prognostic marker.
Authors: Mathieu Nessim Toledano; P Desbordes; A Banjar; I Gardin; P Vera; P Ruminy; F Jardin; H Tilly; S Becker Journal: Eur J Nucl Med Mol Imaging Date: 2018-01-17 Impact factor: 9.236