title: Prognostic implications of serial 18-fluoro-deoxyglucose emission tomography in multiple myeloma treated with total therapy 3.
abstract: Prognostic implications of 3 imaging tools, metastatic bone survey, magnetic resonance imaging, and positron emission tomography (PET), were evaluated in 2 consecutive Total Therapy 3 trials for newly diagnosed myeloma. Data including PET at baseline and on day 7 of induction as well as standard prognostic factors were available in 302 patients of whom 277 also had gene expression profiling (GEP)-derived risk information. According to multivariate analysis, more than 3 focal lesions on day 7 imparted inferior overall survival and progression-free survival, overall and in the subset with GEP-risk data. GEP high-risk designation retained independent significance for all 3 end points examined. Thus, the presence of > 3 focal lesions on day 7 PET follow-up may be exploited toward early therapy change, especially for the 15% of patients with GEP-defined high-risk disease with a median overall survival expectation of 2 years. This trial was registered at www.clinicaltrials.gov as #NCT00081939 and # NCT00572169.
authors.affiliation: Myeloma Institute for Research and Therapy, University of Arkansas for Medical Sciences, Little Rock, AR 72205, USA. susmani@uams.edu
authors.forename: Saad Z
authors.initials: SZ
authors.lastname: Usmani
authors.forename: Alan
authors.initials: A
authors.lastname: Mitchell
authors.forename: Sarah
authors.initials: S
authors.lastname: Waheed
authors.forename: John
authors.initials: J
authors.lastname: Crowley
authors.forename: Antje
authors.initials: A
authors.lastname: Hoering
authors.forename: Nathan
authors.initials: N
authors.lastname: Petty
authors.forename: Tracy
authors.initials: T
authors.lastname: Brown
authors.forename: Twyla
authors.initials: T
authors.lastname: Bartel
authors.forename: Elias
authors.initials: E
authors.lastname: Anaissie
authors.forename: Frits
authors.initials: F
authors.lastname: van Rhee
authors.forename: Bart
authors.initials: B
authors.lastname: Barlogie
mesh_terms: D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D014408:Biomarkers, Tumor / Q000032:analysis*; D001859:Bone Neoplasms / Q000188:drug therapy / Q000401:mortality / Q000556:secondary*; D002986:Clinical Trials as Topic; D019788:Fluorodeoxyglucose F18; D005500:Follow-Up Studies; D020869:Gene Expression Profiling; D006801:Humans; D008279:Magnetic Resonance Imaging; D009101:Multiple Myeloma / Q000188:drug therapy / Q000401:mortality / Q000473:pathology*; D015999:Multivariate Analysis; D009364:Neoplasm Recurrence, Local / Q000188:drug therapy / Q000401:mortality / Q000473:pathology*; D049268:Positron-Emission Tomography; D011379:Prognosis; D019275:Radiopharmaceuticals; D015996:Survival Rate
chemical_list: D014408:Biomarkers, Tumor; D019275:Radiopharmaceuticals; D019788:Fluorodeoxyglucose F18