title: Prognostic relevance of 18-F FDG PET/CT in newly diagnosed multiple myeloma patients treated with up-front autologous transplantation.
abstract: We prospectively analyzed the prognostic relevance of positron emission tomography-computed tomography (PET/CT) at diagnosis, after thalidomide-dexamethasone (TD) induction therapy and double autotransplantation (ASCT) in 192 newly diagnosed multiple myeloma (MM) patients. Presence at baseline of at least 3 focal lesions (FLs; 44% of cases), a standardized uptake value (SUV) > 4.2 (46%), and extramedullary disease (EMD; 6%) adversely affected 4-year estimates of progression-free survival (PFS; ≥ 3 FLs: 50%; SUV > 4.2: 43%; presence of EMD: 28%). SUV > 4.2 and EMD were also correlated with shorter overall survival (OS; 4-year rates: 77% and 66%, respectively). Persistence of SUV > 4.2 after TD induction was an early predictor for shorter PFS. Three months after ASCT, PET/CT was negative in 65% of patients whose 4-year rates of PFS and OS were superior to those of PET-positive patients (PFS: 66% and OS: 89%). In a multivariate analysis, both EMD and SUV > 4.2 at baseline and persistence of fluorodeoxyglucose (FDG) uptake after ASCT were independent variables adversely affecting PFS. PET/CT involvement at diagnosis, after novel agent-based induction and subsequent ASCT is a reliable predictor of prognosis in MM patients. This study is registered at www.clinicaltrials.gov as NTC01341262.
authors: Seràgnoli Institute of Hematology, Bologna University School of Medicine, Bologna, Italy. e.zamagni@unibo.it
authors: Elena
authors: E
authors: Zamagni
authors: Francesca
authors: F
authors: Patriarca
authors: Cristina
authors: C
authors: Nanni
authors: Beatrice
authors: B
authors: Zannetti
authors: Emanuela
authors: E
authors: Englaro
authors: Annalisa
authors: A
authors: Pezzi
authors: Paola
authors: P
authors: Tacchetti
authors: Silvia
authors: S
authors: Buttignol
authors: Giulia
authors: G
authors: Perrone
authors: Annamaria
authors: A
authors: Brioli
authors: Lucia
authors: L
authors: Pantani
authors: Carolina
authors: C
authors: Terragna
authors: Francesca
authors: F
authors: Carobolante
authors: Michele
authors: M
authors: Baccarani
authors: Renato
authors: R
authors: Fanin
authors: Stefano
authors: S
authors: Fanti
authors: Michele
authors: M
authors: Cavo
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003907:Dexamethasone / Q000627:therapeutic use; D019788:Fluorodeoxyglucose F18; D005938:Glucocorticoids / Q000627:therapeutic use; D018380:Hematopoietic Stem Cell Transplantation / Q000379:methods*; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D008875:Middle Aged; D064847:Multimodal Imaging / Q000379:methods*; D009101:Multiple Myeloma / Q000000981:diagnostic imaging / Q000628:therapy; D049268:Positron-Emission Tomography; D011237:Predictive Value of Tests; D011379:Prognosis; D011446:Prospective Studies; D019275:Radiopharmaceuticals; D015996:Survival Rate; D013792:Thalidomide / Q000627:therapeutic use; D014057:Tomography, X-Ray Computed; D014182:Transplantation, Autologous
chemical_list: D005938:Glucocorticoids; D007166:Immunosuppressive Agents; D019275:Radiopharmaceuticals; D019788:Fluorodeoxyglucose F18; D013792:Thalidomide; D003907:Dexamethasone