title: Revisiting the prognostic role of gallium scintigraphy in low-grade non-Hodgkin's lymphoma.
abstract: The purpose of this study was threefold: to evaluate the role of gallium-67 scintigraphy in the staging of low-grade non-Hodgkin's lymphomas (LGNHL), to assess the relationship between the expression of CD71 on the surface of the neoplastic cells and the 67Ga uptake by the tumour, and to establish the contribution of 67Ga scan in defining the prognosis of LGNHL. Forty-eight patients with untreated LGNHL diagnosed in a single institution over a decade were reviewed. The end point of the study was survival of the patients according to the scintigraphic 67Ga score at diagnosis. In addition to 67Ga scan, other prognostic variables were studied, relating to the neoplastic burden, the biology of the tumour and the host. Univariate and multivariate analyses were used. 67Ga scan identified only 116/286 (41%) nodes involved by lymphoma that were detected by clinical examination or computed tomography scan. A scintigraphic scoring system with an arbitrary cut-off value of 3 (high scan score) was able to predict patients with a dismal prognosis: with a mean follow-up of 47 months (range: 1-146 months) the median survival time was 28 months in patients with a high scan score and 74 months in patients with a low scan score (P=0.002). CD71 values were 27. 4%+/-14.9% (mean +/-SD) in the former and 8.9%+/-7.2% in the latter (P=0.0001). Only performance status and extranodal sites were significant variables for prognosis in multivariate analysis. It is concluded that 67Ga scan is inaccurate in staging but might be very important in defining the prognosis in LGNHL, in association with other prognostic variables.
authors.affiliation: Division of Haematology, S. Croce Hospital, Cuneo, Italy.
authors.forename: A
authors.initials: A
authors.lastname: Gallamini
authors.forename: A
authors.initials: A
authors.lastname: Biggi
authors.forename: A
authors.initials: A
authors.lastname: Fruttero
authors.forename: F
authors.initials: F
authors.lastname: Pugno
authors.forename: G
authors.initials: G
authors.lastname: Cavallero
authors.forename: P
authors.initials: P
authors.lastname: Pregno
authors.forename: M
authors.initials: M
authors.lastname: Grasso
authors.forename: C
authors.initials: C
authors.lastname: Farinelli
authors.forename: A
authors.initials: A
authors.lastname: Leone
authors.forename: E
authors.initials: E
authors.lastname: Gallo
mesh_terms: D015703:Antigens, CD / Q000378:metabolism; D000944:Antigens, Differentiation, B-Lymphocyte / Q000378:metabolism; D005260:Female; D005710:Gallium Radioisotopes; D006801:Humans; D008228:Lymphoma, Non-Hodgkin / Q000000981:diagnostic imaging* / Q000401:mortality* / Q000473:pathology; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009367:Neoplasm Staging; D011379:Prognosis; D011990:Receptors, Transferrin / Q000378:metabolism; D012189:Retrospective Studies; D016019:Survival Analysis; D015996:Survival Rate; D013997:Time Factors; D015899:Tomography, Emission-Computed, Single-Photon
chemical_list: D015703:Antigens, CD; D000944:Antigens, Differentiation, B-Lymphocyte; C068126:CD71 antigen; D005710:Gallium Radioisotopes; D011990:Receptors, Transferrin