Adams Hugo J A, Kwee Thomas C, Lokhorst Henk M, Westerweel Peter E, Fijnheer Rob, Kersten Marie José, Verkooijen Helena M, Stoker Jaap, Nievelstein Rutger A J
Department of Radiology and Nuclear Medicine, University Medical Center Utrecht, Utrecht, The Netherlands.
J Magn Reson Imaging. 2014 Jun;39(6):1394-400. doi: 10.1002/jmri.24318. Epub 2013 Nov 14.
To assess the prognostic implications of whole-body bone marrow MRI findings in diffuse large B-cell lymphoma (DLBCL) patients with a negative blind bone marrow biopsy (BMB).
Thirty-eight patients with newly diagnosed DLBCL and negative blind BMB prospectively underwent whole-body MRI (T1-weighted, T2-weighted short inversion time inversion recovery, and diffusion-weighted sequences), which were scored as positive or negative for lymphomatous bone marrow involvement. Proportions of patients who experienced disease relapse/progression or died during follow-up were calculated and compared between whole-body MRI-positive and whole-body MRI-negative patients.
The median follow-up time of surviving patients was 973 days (range, 391-1655 days). Disease relapse/progression occurred in 33% (5/15) of patients with a positive whole-body MRI and in 13% (3/23) of patients with a negative whole-body MRI. In addition, 20% (3/15) of patients with a positive whole-body MRI died during follow-up, compared with 9% (2/23) of patients with a negative whole-body MRI.
The results of this study show that disease relapse or progression and death may occur more frequently in whole-body MRI-positive patients than in whole-body MRI-negative patients, which suggests that whole-body bone marrow MRI findings in DLBCL patients with a negative BMB may have prognostic implications.
评估全身骨髓MRI检查结果对盲法骨髓活检(BMB)阴性的弥漫性大B细胞淋巴瘤(DLBCL)患者的预后意义。
38例新诊断的DLBCL且盲法BMB阴性的患者前瞻性地接受了全身MRI检查(T1加权、T2加权短反转时间反转恢复序列和扩散加权序列),根据淋巴瘤骨髓受累情况将结果分为阳性或阴性。计算并比较全身MRI阳性和阴性患者在随访期间疾病复发/进展或死亡的比例。
存活患者的中位随访时间为973天(范围391 - 1655天)。全身MRI阳性患者中有33%(5/15)发生疾病复发/进展,全身MRI阴性患者中有13%(3/23)发生疾病复发/进展。此外,全身MRI阳性患者中有20%(3/15)在随访期间死亡,而全身MRI阴性患者中有9%(2/23)在随访期间死亡。
本研究结果表明,全身MRI阳性患者比全身MRI阴性患者更易发生疾病复发或进展以及死亡,这提示BMB阴性的DLBCL患者的全身骨髓MRI检查结果可能具有预后意义。