title: Interim positron emission tomography scan associated with international prognostic index and germinal center B cell-like signature as prognostic index in diffuse large B-cell lymphoma.
abstract: [(18)F]-fluorodeoxyglucose positron emission tomography (FDG-PET) imaging is essential to optimize the initial staging and to predict the prognosis of diffuse large B-cell lymphoma (DLBCL). To assess the relationship between the germinal center B cell-like/activated B cell-like (GCB/ABC) classification and PET scan features in DLBCL, 57 cases treated with rituximab and a cyclophosphamide, doxorubicin, vincristine and prednisone (CHOP)/CHOP-like regimen were analyzed. The expression profile of 18 GCB/ABC related genes and five genes coding for glucose transporters (GLUTs) was determined from frozen tissues using DASL (cDNA-mediated Annealing, Selection, Ligation and extension) technology. According to the gene expression profile (GEP), 30 cases of DLBCL were classified as GCB subtype (2-year progression-free survival [PFS] 76%) and 27 cases as ABC subtype (2-year PFS 51%, p = 0.03). Using a semiquantitative assessment of the decrease in standard uptake value (SUV) at interim PET performed after 3-4 cycles of chemotherapy, we defined fast (n = 36) and slow (n = 9) metabolic responders. In multivariate analysis, GCB/ABC subtype, age-adjusted international prognostic index (aaIPI) and slow/fast metabolic response were independent variables that predicted outcome. A score incorporating aaIPI, fast/slow metabolic response and GCB/ABC classification was used to define two groups with highly significantly distinct outcomes. Our study suggests that the combination of GEP, aaIPI and interim PET more accurately predicts DLBCL prognosis and is therefore suitable for tailoring therapeutic strategies.
authors.affiliation: UMR INSERM U918, Centre Henri Becquerel, Rouen, France.
authors.forename: Hélène
authors.initials: H
authors.lastname: Lanic
authors.forename: Sylvain
authors.initials: S
authors.lastname: Mareschal
authors.forename: Férial
authors.initials: F
authors.lastname: Mechken
authors.forename: Jean-Michel
authors.initials: JM
authors.lastname: Picquenot
authors.forename: Marie
authors.initials: M
authors.lastname: Cornic
authors.forename: Catherine
authors.initials: C
authors.lastname: Maingonnat
authors.forename: Philippe
authors.initials: P
authors.lastname: Bertrand
authors.forename: Florian
authors.initials: F
authors.lastname: Clatot
authors.forename: Elodie
authors.initials: E
authors.lastname: Bohers
authors.forename: Aspasia
authors.initials: A
authors.lastname: Stamatoullas
authors.forename: Stéphane
authors.initials: S
authors.lastname: Leprêtre
authors.forename: Vinciane
authors.initials: V
authors.lastname: Rainville
authors.forename: Philippe
authors.initials: P
authors.lastname: Ruminy
authors.forename: Christian
authors.initials: C
authors.lastname: Bastard
authors.forename: Hervé
authors.initials: H
authors.lastname: Tilly
authors.forename: Stéphanie
authors.initials: S
authors.lastname: Becker
authors.forename: Pierre
authors.initials: P
authors.lastname: Vera
authors.forename: Fabrice
authors.initials: F
authors.lastname: Jardin
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D001402:B-Lymphocytes / Q000187:drug effects / Q000378:metabolism / Q000473:pathology*; D003520:Cyclophosphamide / Q000008:administration & dosage; D018572:Disease-Free Survival; D004317:Doxorubicin / Q000008:administration & dosage; D005260:Female; D020869:Gene Expression Profiling; D015972:Gene Expression Regulation, Neoplastic; D018858:Germinal Center / Q000000981:diagnostic imaging* / Q000187:drug effects / Q000378:metabolism; D006801:Humans; D016403:Lymphoma, Large B-Cell, Diffuse / Q000000981:diagnostic imaging* / Q000188:drug therapy / Q000235:genetics; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D020411:Oligonucleotide Array Sequence Analysis; D017063:Outcome Assessment, Health Care / Q000706:statistics & numerical data; D049268:Positron-Emission Tomography / Q000379:methods*; D011241:Prednisone / Q000008:administration & dosage; D011379:Prognosis; D016016:Proportional Hazards Models; D014750:Vincristine / Q000008:administration & dosage; D055815:Young Adult
chemical_list: D014750:Vincristine; D004317:Doxorubicin; D003520:Cyclophosphamide; D011241:Prednisone