King Faisal Specialist Hospital and Research Center, Oncology Center, Riyadh, Saudi Arabia.
Bone Marrow Transplant. 2013 Apr;48(4):551-6. doi: 10.1038/bmt.2012.168. Epub 2012 Sep 10.
(18)F-fluorodeoxyglucose positron emission tomography (FDG-PET) documented response after salvage chemotherapy has been reported to impact survival in patients with aggressive non-Hodgkin's lymphoma, especially diffuse large B cell lymphoma (DLBCL) undergoing high dose chemotherapy and autologous SCT (HDC auto-SCT). We reviewed the impact of 19 different prognostic/predictive factors before salvage chemotherapy and post-salvage chemotherapy FDG-PET results in patients with aggressive lymphoma and developed an FDG-PET integrated model for post-HDC auto-SCT outcome. The Fine and Gray method for competing risk analysis and a regression model was used to assess the risk associated with different factors on outcome. Fifty-five patients had FDG-PET after salvage chemotherapy; male 65%, female 45%, relapsed 55%, refractory 45%, DLBCL 82%, T cell lymphoma 18%, median age at auto-SCT 40 years, median follow-up 42.4 months. Multivariate analysis identified only positive FDG-PET (P=0.04) and mediastinal involvement (P=0.05) with higher hazard rate of disease-specific death (model P=0.008) but only positive FDG-PET (P=0.01) for disease-specific events (persistent, progressive or relapsed disease). Cumulative incidence of disease-specific death for patients with 0, 1 and 2 risk factors was 5, 30 and 62%, respectively (P=0.01). Our model is significant and showed an increasing risk of failure with mediastinal involvement and post-salvage positive FDG-PET.
（18）氟-脱氧葡萄糖正电子发射断层扫描（FDG-PET）在挽救化疗后记录的反应已被报道会影响侵袭性非霍奇金淋巴瘤患者的生存，尤其是接受大剂量化疗和自体干细胞移植（HDC auto-SCT）的弥漫性大 B 细胞淋巴瘤（DLBCL）。我们回顾了挽救化疗前和挽救化疗后 FDG-PET 结果对侵袭性淋巴瘤患者的 19 种不同的预后/预测因素的影响，并建立了一个用于 HDC auto-SCT 后结果的 FDG-PET 综合模型。Fine 和 Gray 方法用于竞争风险分析和回归模型，以评估不同因素与结果相关的风险。55 例患者在挽救化疗后进行了 FDG-PET 检查；男性占 65%，女性占 45%，复发率为 55%，难治性为 45%，DLBCL 为 82%，T 细胞淋巴瘤为 18%，自体 SCT 时的中位年龄为 40 岁，中位随访时间为 42.4 个月。多变量分析仅发现正 FDG-PET（P=0.04）和纵隔受累（P=0.05）与疾病特异性死亡的更高危险率相关（模型 P=0.008），但仅正 FDG-PET（P=0.01）与疾病特异性事件相关（持续性、进行性或复发疾病）。0、1 和 2 个危险因素的患者疾病特异性死亡的累积发生率分别为 5%、30%和 62%（P=0.01）。我们的模型是显著的，显示出随着纵隔受累和挽救化疗后正 FDG-PET 的增加，失败的风险增加。
