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KMID : 1148920200540010028
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Nuclear Medicine and Molecular Imaging
2020 Volume.54 No. 1 p.28 ~ p.34
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Prognostic Value of Bone Marrow F-18 FDG Uptake in Patients with Advanced-Stage Diffuse Large B-Cell Lymphoma
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Wang Ji-Young
Kim Dong-Woo
Kang Won-Jun
Cho Ho-Jin
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Abstract
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Purpose: We assessed prognostic implication of bone marrow uptake on baseline F-18 fluorodeoxyglucose positron emission tomography/computed tomography (FDG PET/CT) in patients with advanced-stage diffuse large B-cell lymphoma (DLBCL).
Methods: We retrospectively reviewed 140 patients with stage III and IV DLBCL, who underwent baseline F-18 FDG PET/CT at diagnosis. Bone marrow uptake on F-18 FDG PET/CT (BM FDG) was compared with findings on bone marrow biopsy (BMB), and patients were grouped based on these results: BMB-positive and BM FDG-positive (group 1), BMB-positive and BM FDG-negative (group 2), BMB-negative and BM FDG-positive (group 3), and BMB-negative and BM FDG-negative (group 4). The prognostic value of clinicopathologic factors and BM FDG for predicting progression-free survival (PFS) and overall survival (OS) was assessed using a Cox proportional hazards model. Differences in PFS and OS were examined by the Kaplan-Meier method.
Results: BMB was the only significant indicator in predicting PFS, and age, IPI score higher than 3, and BM FDG significantly predicted OS. Group 1 showed inferior PFS than group 2 (median PFS, 7.4 vs. 13.9 months; p?=?0.04). In contrast, there was no significant difference either in PFS or OS between group 2 and group 3.
Conclusion: We showed that BM FDG-positive predicted a poorer survival in patients with advanced stage DBLCL. We also found that BMB-negative and BM FDG-positive patients had similar PFS or OS to BMB-positive and BM FDG-negative patients. Further study in a larger population is needed to clarify clinical significance of BM FDG in these patients.
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KEYWORD
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Diffuse large B-cell lymphoma, Fluorodeoxyglucose, Bone marrow involvement, Prognosis
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