Guidot Daniel M, Switchenko Jeffrey M, Nastoupil Loretta J, Koff Jean L, Blum Kristie A, Maly Joseph, Flowers Christopher R, Cohen Jonathon B
a Winship Cancer Institute, Emory University , Atlanta , GA , USA.
b Department of Biostatistics , Emory University , Atlanta , GA , USA.
Leuk Lymphoma. 2018 Apr;59(4):888-895. doi: 10.1080/10428194.2017.1361032. Epub 2017 Aug 10.
Mantle cell lymphoma (MCL) is a heterogeneous disease with high relapse rates. Limited data guide the use of surveillance imaging following treatment. We constructed a retrospective cohort from two academic institutions of patients with MCL who completed first-line therapy and underwent follow-up for relapse, analyzing the effect of surveillance imaging on survival. Of 217 patients, 102 had documented relapse, with 38 (37%) diagnosed by surveillance imaging and 64 (63%) by other methods. Relapse diagnosis by surveillance imaging had no significant advantage in overall survival from diagnosis date (hazard ratio [HR] = 0.80, p = .39) or relapse date (HR = 0.72, p = .22). Of 801 surveillance images, PET/CT had a positive predictive value (PPV) of 24% and number needed-to-scan/treat (NNT) of 51 to detect one relapse, and CT had a PPV of 49% and NNT of 24. For MCL after first-line therapy, relapse detection by surveillance imaging was not associated with improved survival and lacks clinical benefit.
套细胞淋巴瘤（MCL）是一种异质性疾病，复发率高。关于治疗后监测成像的应用，可用数据有限。我们从两家学术机构构建了一个回顾性队列，纳入完成一线治疗并接受复发随访的MCL患者，分析监测成像对生存的影响。在217例患者中，102例有复发记录，其中38例（37%）通过监测成像诊断，64例（63%）通过其他方法诊断。从诊断日期开始计算，监测成像诊断复发在总生存方面没有显著优势（风险比[HR]=0.80，p=0.39），从复发日期开始计算也没有显著优势（HR=0.72，p=0.22）。在801次监测影像中，PET/CT检测到一次复发的阳性预测值（PPV）为24%，扫描/治疗所需人数（NNT）为51，CT的PPV为49%，NNT为24。对于一线治疗后的MCL，通过监测成像检测复发与生存改善无关，且缺乏临床益处。
