Prognostic value of interim FDG PET-CT in patients older than 60 years with diffuse large B-cell lymphoma treated by PMitCEBO plus rituximab. Comparison between Deauville 5-point scale and International Harmonization Project criteria.

Abstract

BACKGROUND:

Advanced age is an independent poor prognostic factor of diffuse large B-cell lymphoma (DLBCL). PMitCEBO (mitoxantrone, cyclophosphamide, etoposide, vincristine, bleomycin, and prednisolone) is an alternative to the cyclophosphamide, doxorubicin, vincristine, and prednisolone regimen to decrease side effects in elderly patients. Many studies have shown prognostic value of an interim FDG PET-CT to predict survival. A recent consensus (ICML, Lugano 2013) has suggested using the 5-point scale Deauville criteria instead of those of the International Harmonization Project (IHP) to visually assess the response on interim PET. The objective of this study was to evaluate the prognostic value of an interim FDG PET-CT in patients older than 60 with treated DLBCL and to compare IHP and 5-PS Deauville visual interpretation to predict survival.

METHODS:

Forty-eight patients (mean age 73.2±5.2 years) treated by R-PMitCEBO for DLBCL undergoing FDG PET-CT before and after 3 cycles of treatment were retrospectively included. Event-free survival and overall survival were determined by Kaplan-Meier method and compared with interim PET-CT results using IHP and 5-PS Deauville criteria.

RESULTS:

Interim PET results using 5-PS Deauville criteria were significantly correlated with EFS (P<0.0001) and OS (P=0.001) whereas they were moderately correlated with EFS (P=0.046) and not with OS (P=0.106) using IHP criteria. Two-year EFS and OS rates were 86.5% and 89.2%, respectively, for patients in 1-3 score group, and 27.3% and 36.4%, respectively, for patients in ≥4 score group using the Deauville criteria.

CONCLUSIONS:

Our results confirmed the prognostic value of an interim PET-CT in elderly patients with DLBCL and the better performance of the 5-PS Deauville criteria.

• Authors: Naelle Lombion, Philippe Robin, Adrian Tempescul, Pierre-Yves LE Roux, Ulrike Schick, Gaëlle Guillerm, Jean-Christophe Ianotto, Christian Berthou, Pierre-Yves Salaün, Ronan Abgral
• Journal: The quarterly journal of nuclear medicine and molecular imaging : official publication of the Italian Association of Nuclear Medicine (AIMN) [and] the International Association of Radiopharmacology (IAR), [and] Section of the Society of... (Q J Nucl Med Mol Imaging) Vol. 65 Issue 4 Pg. 402-409 (12 2021) ISSN: 1827-1936 [Electronic] Italy
• PMID: 35133099 (Publication Type: Journal Article)

Chemical References

• Fluorodeoxyglucose F18
• Bleomycin
• Rituximab
• Vincristine
• Etoposide
• Cyclophosphamide
• Prednisolone
• Mitoxantrone

Topics

• Aged
• Antineoplastic Combined Chemotherapy Protocols (therapeutic use)
• Bleomycin (therapeutic use)
• Cyclophosphamide (therapeutic use)
• Etoposide (therapeutic use)
• Fluorodeoxyglucose F18
• Humans
• Lymphoma, Large B-Cell, Diffuse (diagnostic imaging, drug therapy)
• Mitoxantrone (therapeutic use)
• Positron Emission Tomography Computed Tomography
• Positron-Emission Tomography
• Prednisolone (therapeutic use)
• Prognosis
• Retrospective Studies
• Rituximab (therapeutic use)
• Vincristine (therapeutic use)