title: Interim 18-FDG-PET/CT failed to predict the outcome in diffuse large B-cell lymphoma patients treated at the diagnosis with rituximab-CHOP.
abstract: Role of interim-PET (I-PET) in diffuse large B-cell Lymphoma (DLBCL) is controversial. To determine predictive value of I-PET on progression-free survival (PFS), we enrolled 88 first-line DLBCL patients treated with 6-8 R-CHOP courses regardless of I-PET. PET/CT were performed at diagnosis, after 2 to 4 courses and at the end of therapy with central reviewing according to visual dichotomous criteria. Results are as follows: I-PET, 72% negative, 28% positive; final-PET (F-PET), 88% negative, 12% positive; clinical complete response 90%. Concordance between clinical response and F-PET negativity was 97% because of 2 false positive. With a median follow-up of 26.2 months, 2-year overall survival and PFS were 91% and 77%, respectively. Two-year PFS for I-PET and F-PET negative versus positive were as follows: I-PET 85% versus 72% (P = .0475); F-PET 83% versus 64% (P < .001). Because of a small number of events, 2 independent bivariate Cox models were tested for PFS. In model 1, F-PET contradicted I-PET (hazard ratio [HR] = 5.03, P = .015 vs 1.27, P = 691); in model 2, F-PET (HR = 4.54) and International propnostic Index score (HR = 5.36, P = .001) remained independent prognostic factors. In conclusion, positive I-PET is not predictive of a worse outcome in DLBCL; larger prospective studies and harmonization of I-PET reading criteria are needed.
authors.affiliation: Hematology 2, San Giovanni Battista Hospital and University, Corso Bramante 88, Turin, Italy. ppregno@molinette.piemonte.it
authors.forename: Patrizia
authors.initials: P
authors.lastname: Pregno
authors.forename: Annalisa
authors.initials: A
authors.lastname: Chiappella
authors.forename: Marilena
authors.initials: M
authors.lastname: Bellò
authors.forename: Barbara
authors.initials: B
authors.lastname: Botto
authors.forename: Simone
authors.initials: S
authors.lastname: Ferrero
authors.forename: Silvia
authors.initials: S
authors.lastname: Franceschetti
authors.forename: Francesca
authors.initials: F
authors.lastname: Giunta
authors.forename: Marco
authors.initials: M
authors.lastname: Ladetto
authors.forename: Giorgio
authors.initials: G
authors.lastname: Limerutti
authors.forename: Massimo
authors.initials: M
authors.lastname: Menga
authors.forename: Maura
authors.initials: M
authors.lastname: Nicolosi
authors.forename: Giorgio
authors.initials: G
authors.lastname: Priolo
authors.forename: Benedetta
authors.initials: B
authors.lastname: Puccini
authors.forename: Luigi
authors.initials: L
authors.lastname: Rigacci
authors.forename: Flavia
authors.initials: F
authors.lastname: Salvi
authors.forename: Luca
authors.initials: L
authors.lastname: Vaggelli
authors.forename: Roberto
authors.initials: R
authors.lastname: Passera
authors.forename: Gianni
authors.initials: G
authors.lastname: Bisi
authors.forename: Umberto
authors.initials: U
authors.lastname: Vitolo
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D058846:Antibodies, Monoclonal, Murine-Derived / Q000627:therapeutic use*; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D003520:Cyclophosphamide / Q000627:therapeutic use; D004317:Doxorubicin / Q000627:therapeutic use; D005260:Female; D019788:Fluorodeoxyglucose F18; D006801:Humans; D016403:Lymphoma, Large B-Cell, Diffuse / Q000000981:diagnostic imaging* / Q000188:drug therapy* / Q000401:mortality; D008297:Male; D008875:Middle Aged; D064847:Multimodal Imaging; D009367:Neoplasm Staging; D049268:Positron-Emission Tomography; D011241:Prednisone / Q000627:therapeutic use; D011379:Prognosis; D012189:Retrospective Studies; D000069283:Rituximab; D016019:Survival Analysis; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D014750:Vincristine / Q000627:therapeutic use; D055815:Young Adult
chemical_list: D058846:Antibodies, Monoclonal, Murine-Derived; D019788:Fluorodeoxyglucose F18; D000069283:Rituximab; D014750:Vincristine; D004317:Doxorubicin; D003520:Cyclophosphamide; D011241:Prednisone