Skip to main content
Erschienen in: Annals of Hematology 5/2009

01.05.2009 | Original Article

The combined evaluation of interim contrast-enhanced computerized tomography (CT) and FDG-PET/CT predicts the clinical outcomes and may impact on the therapeutic plans in patients with aggressive non-Hodgkin’s lymphoma

verfasst von: Deok-Hwan Yang, Jung-Joon Min, Yong Yeon Jeong, Jae-Sook Ahn, Yeo-Kyeoung Kim, Sang-Hee Cho, Ik-Joo Chung, Hee-Seung Bom, Hyeoung-Joon Kim, Je-Jung Lee

Erschienen in: Annals of Hematology | Ausgabe 5/2009

Einloggen, um Zugang zu erhalten

Abstract

We investigated the concomitant interim response of patients with aggressive non-Hodgkin’s lymphoma (NHL) using multi-detector row computerized tomography (CT) and 18F-fluoro-2-deoxy-d-glucose-positron emission tomography (PET)/CT for prediction of clinical outcomes. One hundred six newly diagnosed patients with aggressive NHL were enrolled. Both the CT and PET/CT were serially performed at the time of diagnosis and after three to four cycles of chemotherapy (interim). The patients were categorized into four different responsive groups according to the interim PET/CT and CT: (1) complete metabolic response (CMR)–complete response unconfirmed (CRu), (2) CMR–partial response (PR), (3) partial metabolic response (PMR)–Cru, and (4) PMR–PR. Fifty-five patients with CMR–CRu, 20 patients with CMR–PR, seven patients with PMR–Cru, and 23 patients with PMR–PR were distributed. In addition, one patient experienced a disease progression. There was a significant difference in relapse rates between PET/CT-positive (67.3%) and PET/CT-negative patients (17.3%; P < 0.01). Also, there was a significant difference between patients with PMR–PR (32.0% and 26.1%) and CMR–CRu (89.3% and 80.0%) for 3-year overall survival (OS) and event-free survival (EFS), respectively. A multivariate analysis revealed that high international prognostic index (≥3) at diagnosis, T-cell phenotype, and PMR–PR in interim PET/CT and CT were independent prognostic significances for OS. Moreover, bulky disease (>10 cm), T-cell phenotype, and PMR–PR showed significant associations for EFS. PMR–PR in interim response was the predictive prognostic determinant for both OS and EFS, with a hazard ratio of 3.93 (1.61–9.60) and 3.60 (1.62–7.98), respectively. The combined evaluation of interim PET/CT and CT was found to be a significant predictor of disease progression, OS, and EFS.
Literatur
1.
Zurück zum Zitat Spaepen K, Stroobants S, Dupont P, Van Steenweghen S, Thomas J, Vandenberghe P et al (2001) Prognostic value of positron emission tomography (PET) with fluorine-18 fluorodeoxyglucose ([18F]FDG) after first-line chemotherapy in non-Hodgkin’s lymphoma: is [18F]FDG-PET a valid alternative to conventional diagnostic methods? J Clin Oncol 19:414–419PubMed Spaepen K, Stroobants S, Dupont P, Van Steenweghen S, Thomas J, Vandenberghe P et al (2001) Prognostic value of positron emission tomography (PET) with fluorine-18 fluorodeoxyglucose ([18F]FDG) after first-line chemotherapy in non-Hodgkin’s lymphoma: is [18F]FDG-PET a valid alternative to conventional diagnostic methods? J Clin Oncol 19:414–419PubMed
2.
Zurück zum Zitat Jerusalem G, Beguin Y, Fassotte MF, Najjar F, Paulus P, Rigo P et al (1999) Whole-body positron emission tomography using 18F-fluorodeoxyglucose for posttreatment evaluation in Hodgkin’s disease and non-Hodgkin’s lymphoma has higher diagnostic and prognostic value than classical computed tomography scan imaging. Blood 94:429–433PubMed Jerusalem G, Beguin Y, Fassotte MF, Najjar F, Paulus P, Rigo P et al (1999) Whole-body positron emission tomography using 18F-fluorodeoxyglucose for posttreatment evaluation in Hodgkin’s disease and non-Hodgkin’s lymphoma has higher diagnostic and prognostic value than classical computed tomography scan imaging. Blood 94:429–433PubMed
3.
Zurück zum Zitat Mikhaeel NG, Timothy AR, O’Doherty MJ, Hain S, Maisey MN (2000) 18-FDG-PET as a prognostic indicator in the treatment of aggressive non-Hodgkin’s lymphoma—comparison with CT. Leuk Lymphoma 39:543–553PubMed Mikhaeel NG, Timothy AR, O’Doherty MJ, Hain S, Maisey MN (2000) 18-FDG-PET as a prognostic indicator in the treatment of aggressive non-Hodgkin’s lymphoma—comparison with CT. Leuk Lymphoma 39:543–553PubMed
4.
Zurück zum Zitat Cheson BD, Horning SJ, Coiffier B, Shipp MA, Fisher RI, Connors JM et al (1999) Report of an international workshop to standardize response criteria for non-Hodgkin’s lymphomas. NCI Sponsored International Working Group. J Clin Oncol 17:1244PubMed Cheson BD, Horning SJ, Coiffier B, Shipp MA, Fisher RI, Connors JM et al (1999) Report of an international workshop to standardize response criteria for non-Hodgkin’s lymphomas. NCI Sponsored International Working Group. J Clin Oncol 17:1244PubMed
5.
Zurück zum Zitat Surbone A, Longo DL, DeVita VT Jr, Ihde DC, Duffey PL, Jaffe ES et al (1988) Residual abdominal masses in aggressive non-Hodgkin’s lymphoma after combination chemotherapy: significance and management. J Clin Oncol 6:1832–1837PubMed Surbone A, Longo DL, DeVita VT Jr, Ihde DC, Duffey PL, Jaffe ES et al (1988) Residual abdominal masses in aggressive non-Hodgkin’s lymphoma after combination chemotherapy: significance and management. J Clin Oncol 6:1832–1837PubMed
6.
Zurück zum Zitat Coiffier B, Gisselbrecht C, Herbrecht R, Tilly H, Bosly A, Brousse N (1989) LNH-84 regimen: a multicenter study of intensive chemotherapy in 737 patients with aggressive malignant lymphoma. J Clin Oncol 7:1018–1026PubMed Coiffier B, Gisselbrecht C, Herbrecht R, Tilly H, Bosly A, Brousse N (1989) LNH-84 regimen: a multicenter study of intensive chemotherapy in 737 patients with aggressive malignant lymphoma. J Clin Oncol 7:1018–1026PubMed
7.
Zurück zum Zitat Canellos GP (1988) Residual mass in lymphoma may not be residual disease. J Clin Oncol 6:931–933PubMed Canellos GP (1988) Residual mass in lymphoma may not be residual disease. J Clin Oncol 6:931–933PubMed
8.
Zurück zum Zitat Kostakoglu L, Coleman M, Leonard JP, Kuji I, Zoe H, Goldsmith SJ (2002) PET predicts prognosis after 1 cycle of chemotherapy in aggressive lymphoma and Hodgkin’s disease. J Nucl Med 43:1018–1027PubMed Kostakoglu L, Coleman M, Leonard JP, Kuji I, Zoe H, Goldsmith SJ (2002) PET predicts prognosis after 1 cycle of chemotherapy in aggressive lymphoma and Hodgkin’s disease. J Nucl Med 43:1018–1027PubMed
9.
Zurück zum Zitat Kostakoglu L (2002) Noninvasive detection of multidrug resistance in patients with hematological malignancies: are we there yet? Clin Lymphoma 2:242–248PubMedCrossRef Kostakoglu L (2002) Noninvasive detection of multidrug resistance in patients with hematological malignancies: are we there yet? Clin Lymphoma 2:242–248PubMedCrossRef
10.
Zurück zum Zitat Querellou S, Valette F, Bodet-Milin C, Oudoux A, Carlier T, Harousseau JL et al (2006) FDG-PET/CT predicts outcome in patients with aggressive non-Hodgkin’s lymphoma and Hodgkin’s disease. Ann Hematol 85:759–767 doi:10.1007/s00277-006-0151-z PubMedCrossRef Querellou S, Valette F, Bodet-Milin C, Oudoux A, Carlier T, Harousseau JL et al (2006) FDG-PET/CT predicts outcome in patients with aggressive non-Hodgkin’s lymphoma and Hodgkin’s disease. Ann Hematol 85:759–767 doi:10.​1007/​s00277-006-0151-z PubMedCrossRef
11.
Zurück zum Zitat Picardi M, De Renzo A, Pane F, Nicolai E, Pacelli R, Salvatore M et al (2007) Randomized comparison of consolidation radiation versus observation in bulky Hodgkin’s lymphoma with post-chemotherapy negative positron emission tomography scans. Leuk Lymphoma 48:1721–1727 doi:10.1080/10428190701559140 PubMedCrossRef Picardi M, De Renzo A, Pane F, Nicolai E, Pacelli R, Salvatore M et al (2007) Randomized comparison of consolidation radiation versus observation in bulky Hodgkin’s lymphoma with post-chemotherapy negative positron emission tomography scans. Leuk Lymphoma 48:1721–1727 doi:10.​1080/​1042819070155914​0 PubMedCrossRef
12.
Zurück zum Zitat Zhao J, Qiao W, Wang C, Wang T, Xing Y (2007) Therapeutic evaluation and prognostic value of interim hybrid PET/CT with (18)F-FDG after three to four cycles of chemotherapy in non-Hodgkin’s lymphoma. Hematology 12(5):423–430PubMedCrossRef Zhao J, Qiao W, Wang C, Wang T, Xing Y (2007) Therapeutic evaluation and prognostic value of interim hybrid PET/CT with (18)F-FDG after three to four cycles of chemotherapy in non-Hodgkin’s lymphoma. Hematology 12(5):423–430PubMedCrossRef
13.
Zurück zum Zitat Fields PA, Mikhaeel G, Hutchings M, van der Walt J, Nunan T, Schey SA (2005) The prognostic value of interim positron emission tomography scans combined with immunohistochemical data in diffuse large B-cell lymphoma. Haematologica 90:1711–1713PubMed Fields PA, Mikhaeel G, Hutchings M, van der Walt J, Nunan T, Schey SA (2005) The prognostic value of interim positron emission tomography scans combined with immunohistochemical data in diffuse large B-cell lymphoma. Haematologica 90:1711–1713PubMed
14.
Zurück zum Zitat (1993) A predictive model for aggressive non-Hodgkin’s lymphoma. The International Non-Hodgkin’s Lymphoma Prognostic Factors Project. N Engl J Med 329:987–994. doi:10.1056/NEJM199309303291402 (1993) A predictive model for aggressive non-Hodgkin’s lymphoma. The International Non-Hodgkin’s Lymphoma Prognostic Factors Project. N Engl J Med 329:987–994. doi:10.​1056/​NEJM199309303291​402
15.
Zurück zum Zitat Rosenwald A, Wright G, Chan WC, Connors JM, Campo E, Fisher RI et al (2002) The use of molecular profiling to predict survival after chemotherapy for diffuse large-B-cell lymphoma. N Engl J Med 346:1937–1947 doi:10.1056/NEJMoa012914 PubMedCrossRef Rosenwald A, Wright G, Chan WC, Connors JM, Campo E, Fisher RI et al (2002) The use of molecular profiling to predict survival after chemotherapy for diffuse large-B-cell lymphoma. N Engl J Med 346:1937–1947 doi:10.​1056/​NEJMoa012914 PubMedCrossRef
16.
Zurück zum Zitat Sehn LH, Berry B, Chhanabhai M, Fitzgerald C, Gill K, Hoskins P et al (2007) The revised International Prognostic Index (R-IPI) is a better predictor of outcome than the standard IPI for patients with diffuse large B-cell lymphoma treated with R-CHOP. Blood 109:1857–1861 doi:10.1182/blood-2006-08-038257 PubMedCrossRef Sehn LH, Berry B, Chhanabhai M, Fitzgerald C, Gill K, Hoskins P et al (2007) The revised International Prognostic Index (R-IPI) is a better predictor of outcome than the standard IPI for patients with diffuse large B-cell lymphoma treated with R-CHOP. Blood 109:1857–1861 doi:10.​1182/​blood-2006-08-038257 PubMedCrossRef
17.
Zurück zum Zitat Armitage JO, Weisenburger DD, Hutchins M, Moravec DF, Dowling M, Sorensen S et al (1986) Chemotherapy for diffuse large-cell lymphoma—rapidly responding patients have more durable remissions. J Clin Oncol 4:160–164PubMed Armitage JO, Weisenburger DD, Hutchins M, Moravec DF, Dowling M, Sorensen S et al (1986) Chemotherapy for diffuse large-cell lymphoma—rapidly responding patients have more durable remissions. J Clin Oncol 4:160–164PubMed
18.
Zurück zum Zitat Rodriguez-Catarino M, Jerkeman M, Ahlstrom H, Glimelius B, Hagberg H (2000) Residual mass in aggressive lymphoma–does size, measured by computed tomography, influence clinical outcome? Acta Oncol 39:485–489 doi:10.1080/028418600750013393 PubMedCrossRef Rodriguez-Catarino M, Jerkeman M, Ahlstrom H, Glimelius B, Hagberg H (2000) Residual mass in aggressive lymphoma–does size, measured by computed tomography, influence clinical outcome? Acta Oncol 39:485–489 doi:10.​1080/​0284186007500133​93 PubMedCrossRef
19.
Zurück zum Zitat Haioun C, Itti E, Rahmouni A, Brice P, Rain JD, Belhadj K et al (2005) [18F]fluoro-2-deoxy-D-glucose positron emission tomography (FDG-PET) in aggressive lymphoma: an early prognostic tool for predicting patient outcome. Blood 106:1376–1381 doi:10.1182/blood-2005-01-0272 PubMedCrossRef Haioun C, Itti E, Rahmouni A, Brice P, Rain JD, Belhadj K et al (2005) [18F]fluoro-2-deoxy-D-glucose positron emission tomography (FDG-PET) in aggressive lymphoma: an early prognostic tool for predicting patient outcome. Blood 106:1376–1381 doi:10.​1182/​blood-2005-01-0272 PubMedCrossRef
20.
Zurück zum Zitat Mikhaeel NG, Hutchings M, Fields PA, O’Doherty MJ, Timothy AR (2005) FDG-PET after two to three cycles of chemotherapy predicts progression-free and overall survival in high-grade non-Hodgkin lymphoma. Ann Oncol 16:1514–1523 doi:10.1093/annonc/mdi272 PubMedCrossRef Mikhaeel NG, Hutchings M, Fields PA, O’Doherty MJ, Timothy AR (2005) FDG-PET after two to three cycles of chemotherapy predicts progression-free and overall survival in high-grade non-Hodgkin lymphoma. Ann Oncol 16:1514–1523 doi:10.​1093/​annonc/​mdi272 PubMedCrossRef
21.
22.
Zurück zum Zitat Hutchings M, Loft A, Hansen M, Pedersen LM, Buhl T, Jurlander J et al (2006) FDG-PET after two cycles of chemotherapy predicts treatment failure and progression-free survival in Hodgkin lymphoma. Blood 107:52–59 doi:10.1182/blood-2005-06-2252 PubMedCrossRef Hutchings M, Loft A, Hansen M, Pedersen LM, Buhl T, Jurlander J et al (2006) FDG-PET after two cycles of chemotherapy predicts treatment failure and progression-free survival in Hodgkin lymphoma. Blood 107:52–59 doi:10.​1182/​blood-2005-06-2252 PubMedCrossRef
23.
Zurück zum Zitat Lapela M, Leskinen S, Minn HR, Lindholm P, Klemi PJ, Soderstrom KO et al (1995) Increased glucose metabolism in untreated non-Hodgkin’s lymphoma: a study with positron emission tomography and fluorine-18-fluorodeoxyglucose. Blood 86:3522–3527PubMed Lapela M, Leskinen S, Minn HR, Lindholm P, Klemi PJ, Soderstrom KO et al (1995) Increased glucose metabolism in untreated non-Hodgkin’s lymphoma: a study with positron emission tomography and fluorine-18-fluorodeoxyglucose. Blood 86:3522–3527PubMed
24.
Zurück zum Zitat Schoder H, Noy A, Gonen M, Weng L, Green D, Erdi YE et al (2005) Intensity of 18fluorodeoxyglucose uptake in positron emission tomography distinguishes between indolent and aggressive non-Hodgkin’s lymphoma. J Clin Oncol 23:4643–4651 doi:10.1200/JCO.2005.12.072 PubMedCrossRef Schoder H, Noy A, Gonen M, Weng L, Green D, Erdi YE et al (2005) Intensity of 18fluorodeoxyglucose uptake in positron emission tomography distinguishes between indolent and aggressive non-Hodgkin’s lymphoma. J Clin Oncol 23:4643–4651 doi:10.​1200/​JCO.​2005.​12.​072 PubMedCrossRef
25.
Zurück zum Zitat Reinhardt MJ, Herkel C, Altehoefer C, Finke J, Moser E (2005) Computed tomography and 18F-FDG positron emission tomography for therapy control of Hodgkin’s and non-Hodgkin’s lymphoma patients: when do we really need FDG-PET? Ann Oncol 16:1524–1529 doi:10.1093/annonc/mdi271 PubMedCrossRef Reinhardt MJ, Herkel C, Altehoefer C, Finke J, Moser E (2005) Computed tomography and 18F-FDG positron emission tomography for therapy control of Hodgkin’s and non-Hodgkin’s lymphoma patients: when do we really need FDG-PET? Ann Oncol 16:1524–1529 doi:10.​1093/​annonc/​mdi271 PubMedCrossRef
Metadaten
Titel
The combined evaluation of interim contrast-enhanced computerized tomography (CT) and FDG-PET/CT predicts the clinical outcomes and may impact on the therapeutic plans in patients with aggressive non-Hodgkin’s lymphoma
verfasst von
Deok-Hwan Yang
Jung-Joon Min
Yong Yeon Jeong
Jae-Sook Ahn
Yeo-Kyeoung Kim
Sang-Hee Cho
Ik-Joo Chung
Hee-Seung Bom
Hyeoung-Joon Kim
Je-Jung Lee
Publikationsdatum
01.05.2009
Verlag
Springer-Verlag
Erschienen in
Annals of Hematology / Ausgabe 5/2009
Print ISSN: 0939-5555
Elektronische ISSN: 1432-0584
DOI
https://doi.org/10.1007/s00277-008-0616-3

Weitere Artikel der Ausgabe 5/2009

Annals of Hematology 5/2009 Zur Ausgabe

Leitlinien kompakt für die Innere Medizin

Mit medbee Pocketcards sicher entscheiden.

Seit 2022 gehört die medbee GmbH zum Springer Medizin Verlag

Reizdarmsyndrom: Diäten wirksamer als Medikamente

29.04.2024 Reizdarmsyndrom Nachrichten

Bei Reizdarmsyndrom scheinen Diäten, wie etwa die FODMAP-arme oder die kohlenhydratreduzierte Ernährung, effektiver als eine medikamentöse Therapie zu sein. Das hat eine Studie aus Schweden ergeben, die die drei Therapieoptionen im direkten Vergleich analysierte.

Notfall-TEP der Hüfte ist auch bei 90-Jährigen machbar

26.04.2024 Hüft-TEP Nachrichten

Ob bei einer Notfalloperation nach Schenkelhalsfraktur eine Hemiarthroplastik oder eine totale Endoprothese (TEP) eingebaut wird, sollte nicht allein vom Alter der Patientinnen und Patienten abhängen. Auch über 90-Jährige können von der TEP profitieren.

Niedriger diastolischer Blutdruck erhöht Risiko für schwere kardiovaskuläre Komplikationen

25.04.2024 Hypotonie Nachrichten

Wenn unter einer medikamentösen Hochdrucktherapie der diastolische Blutdruck in den Keller geht, steigt das Risiko für schwere kardiovaskuläre Ereignisse: Darauf deutet eine Sekundäranalyse der SPRINT-Studie hin.

Bei schweren Reaktionen auf Insektenstiche empfiehlt sich eine spezifische Immuntherapie

Insektenstiche sind bei Erwachsenen die häufigsten Auslöser einer Anaphylaxie. Einen wirksamen Schutz vor schweren anaphylaktischen Reaktionen bietet die allergenspezifische Immuntherapie. Jedoch kommt sie noch viel zu selten zum Einsatz.

Update Innere Medizin

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.