Division of Haematology and Medical Oncology, Peter MacCallum Cancer Centre, East Melbourne, VIC, Australia.
Br J Haematol. 2010 Jul;150(1):39-45. doi: 10.1111/j.1365-2141.2010.08162.x. Epub 2010 May 7.
The utility of ([18F])fluoro-2-deoxy- d-glucose positron-emission tomography (FDG-PET) for predicting outcome after autologous stem cell transplantation (ASCT) for diffuse large B cell lymphoma (DLBCL) is uncertain - existing studies include a range of histological subtypes or have a limited duration of follow-up. Thirty-nine patients with primary-refractory or relapsed DLBCL with pre-ASCT PET scans were analysed. The median follow-up was 3 years. The 3-year progression-free survival (PFS) for patients with positive PET scans pre-ASCT was 35% vs. 81% for those who had negative PET scans (P = 0.003). The overall survival (OS) in these groups was 39% and 81% (P = 0.01), respectively. In a multivariate analysis, PET result, number of salvage cycles and the presence of relapsed or refractory disease were shown to predict a longer PFS; PET negativity (P = 0.04) was predictive of a longer OS. PET is useful for defining those with an excellent prognosis post-ASCT. Although those with positive scans can still be salvaged with current treatments, PET may useful for selecting patients eligible for novel consolidation strategies after salvage therapies.
氟代脱氧葡萄糖正电子发射断层扫描（FDG-PET）在预测自体干细胞移植（ASCT）后弥漫性大 B 细胞淋巴瘤（DLBCL）结局中的作用尚不确定-现有研究包括一系列组织学亚型，或随访时间有限。对 39 例原发性耐药或复发的 DLBCL 患者进行了 ASCT 前 PET 扫描分析。中位随访时间为 3 年。ASCT 前 PET 扫描阳性患者的 3 年无进展生存率（PFS）为 35%，而 PET 扫描阴性患者为 81%（P=0.003）。这些组别的总生存率（OS）分别为 39%和 81%（P=0.01）。在多变量分析中，PET 结果、挽救性化疗周期数以及是否存在复发或难治性疾病被证明可以预测更长的 PFS；PET 阴性（P=0.04）预测 OS 更长。PET 可用于确定 ASCT 后预后良好的患者。尽管阳性扫描的患者仍可通过目前的治疗挽救，但 PET 可能有助于选择在挽救性治疗后适合新型巩固策略的患者。
