Becherer A, Mitterbauer M, Jaeger U, Kalhs P, Greinix H T, Karanikas G, Pötzi C, Raderer M, Dudczak R, Kletter K
Department of Nuclear Medicine, Internal Medicine I, University of Vienna, Medical School, Vienna, Austria.
Leukemia. 2002 Feb;16(2):260-7. doi: 10.1038/sj.leu.2402342.
We have determined the predictive value of [18F]2-fluoro-2-deoxy-glucose (FDG-PET) in patients with Hodgkin's disease (HD) and aggressive non-Hodgkin's lymphoma (NHL) scheduled for high-dose therapy with stem cell transplantation (HDT/SCT). Inclusion criteria were the presence of an FDG-PET scan after chemotherapy (ChT) within 8 weeks prior to HDT/SCT and available follow-up data. Sixteen patients (10 NHL and six HD) were observed during a follow-up period of 4 to 28 months (median 13 months). Before SCT, five patients had a negative PET, three were weakly positive, two moderately positive, and six strongly positive. None of the five patients with a negative PET before HDT/SCT relapsed and two of three patients with a weakly positive scan are still in remission after HDT/SCT. Of eight patients with a moderate or high positive PET before HDT/SCT, seven relapsed and one died of early HDT/SCT related complications (P< 0.01). Three of eight relapsing patients died of lymphoma 5 to 10 months after SCT and in one additional patient not responding to HDT/SCT, the main cause of death was chronic toxicity 4 months after transplantation. After 12 months, in PET-negative patients the overall and relapse-free survival was 100%, in PET-positive patients 55% and 18%, respectively. In NHL, two patients with negative PET, but with an age-adjusted international prognostic index (AaIPI) of 2 and one with AaIPI = 1 are still in remission. In the seven PET-positive subjects, one patient with AaIPI = 0, three with AaIPI = 1, and two with AaIPI = 2 relapsed. We conclude that FDG-PET is accurate in the prediction of relapse prior to HDT/SCT in patients with lymphoma. It provides additional information when compared with the AaIPI.
我们已经确定了[18F]2-氟-2-脱氧葡萄糖（FDG-PET）在计划进行高剂量干细胞移植治疗（HDT/SCT）的霍奇金淋巴瘤（HD）和侵袭性非霍奇金淋巴瘤（NHL）患者中的预测价值。纳入标准为在HDT/SCT前8周内化疗（ChT）后进行了FDG-PET扫描且有可用的随访数据。在4至28个月（中位时间13个月）的随访期内观察了16例患者（10例NHL和6例HD）。在干细胞移植前，5例患者PET为阴性，3例弱阳性，2例中度阳性，6例强阳性。HDT/SCT前PET阴性的5例患者均未复发，3例弱阳性扫描患者中有2例在HDT/SCT后仍处于缓解期。HDT/SCT前PET中度或高度阳性的8例患者中，7例复发，1例死于HDT/SCT早期相关并发症（P<0.01）。8例复发患者中有3例在干细胞移植后5至10个月死于淋巴瘤，在另外1例对HDT/SCT无反应的患者中，主要死亡原因是移植后4个月的慢性毒性。12个月后，PET阴性患者的总生存率和无复发生存率均为100%，PET阳性患者分别为55%和18%。在NHL中，2例PET阴性但年龄校正国际预后指数（AaIPI）为2的患者和1例AaIPI = 1的患者仍处于缓解期。在7例PET阳性受试者中，1例AaIPI = 0的患者、3例AaIPI = 1的患者和2例AaIPI = 2的患者复发。我们得出结论，FDG-PET在预测淋巴瘤患者HDT/SCT前的复发方面是准确的。与AaIPI相比，它提供了额外的信息。
