Division of Hematology-Oncology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
Acta Haematol. 2014;131(4):193-9. doi: 10.1159/000354839. Epub 2013 Nov 26.
Recently, positron emission tomography (PET) has been incorporated into a series of prospective studies as a predictor of outcomes in multiple myeloma (MM), and the number of (18)F-fluorodeoxuglucose (FDG)-avid focal lesions (FLs) and the intensity of tumor metabolism have been designated as important surrogate markers for predicting prognosis. Here, we compared initial clinical characteristics of MM patients with baseline PET parameters: the number of FLs and the maximum standardized uptake value (SUVmax). A total of 59 patients diagnosed with MM between August 2004 and February 2012 were reviewed. At diagnosis, 23 patients (40.0%) had ≤3 FLs, 11 patients (18.6%) 4-9 FLs, and 25 patients (42.4%) ≥10 FLs. The median SUVmax was 5.3 (range 0-24.3), and 40 patients (67.8%) showed a SUVmax >4. No clinical characteristics were significantly different between groups with a SUVmax ≤4 and a SUVmax >4. However, there were significant differences in several clinical indices between the FLs ≤3 and FLs >3 groups; elevated β2-microglobulin, elevated lactate dehydrogenase, anemia and more advanced disease by the Durie-Salmon stage corresponded to FLs >3 at baseline PET. Adverse baseline PET findings are positively correlated with prognostically relevant clinical parameters. Regarding PET parameters, FLs are more likely to be well correlated with disease aggressiveness and pathophysiology compared to SUVmax.
最近，正电子发射断层扫描（PET）已被纳入一系列多发性骨髓瘤（MM）的前瞻性研究中，作为预测结果的指标，（18）F-氟脱氧葡萄糖（FDG）摄取的局灶性病变（FLs）数量和肿瘤代谢强度已被指定为预测预后的重要替代标志物。在这里，我们比较了 MM 患者的初始临床特征与基线 PET 参数：FLs 的数量和最大标准化摄取值（SUVmax）。共回顾了 2004 年 8 月至 2012 年 2 月期间诊断为 MM 的 59 例患者。在诊断时，23 例（40.0%）患者的 FLs 数≤3，11 例（18.6%）患者的 FLs 数为 4-9，25 例（42.4%）患者的 FLs 数≥10。SUVmax 的中位数为 5.3（范围 0-24.3），40 例（67.8%）患者 SUVmax＞4。SUVmax≤4 和 SUVmax＞4 两组之间的临床特征无显著差异。然而，在 FLs≤3 和 FLs＞3 两组之间，几个临床指标存在显著差异；基线 PET 时，β2-微球蛋白升高、乳酸脱氢酶升高、贫血和 Durie-Salmon 分期更晚期的疾病与 FLs＞3 相关。不良的基线 PET 发现与预后相关的临床参数呈正相关。关于 PET 参数，与 SUVmax 相比，FLs 更可能与疾病侵袭性和病理生理学密切相关。
