弥漫性大 B 细胞淋巴瘤的中期 PET/CT 检查有助于在 IPI 分层患者中确定预后良好的患者。

Interim PET/CT in diffuse large B-cell lymphoma may facilitate identification of good-prognosis patients among IPI-stratified patients.

机构信息

Department of Hematology, Faculty of Medicine, University of Debrecen, Nagyerdei krt. 98, 4032, Debrecen, Hungary.

Department of Nuclear Medicine, Faculty of Medicine, University of Debrecen, Debrecen, Hungary.

出版信息

Int J Hematol. 2019 Sep;110(3):331-339. doi: 10.1007/s12185-019-02690-2. Epub 2019 Jun 21.

Abstract

Treating patients with DLBCL remains a challenge, as the response to first-line immunochemotherapy is somewhat unpredictable. The International Prognostic Index (IPI) is one of the most widely used methods for assessing prognosis. Interim PET/CT (iPET/CT) can play an important role in the early identification of 'non-responder' patients before the end of treatment examination. In this study, we retrospectively analyzed 104 newly diagnosed DLBCL patients treated with R-CHOP-like regimens who underwent iPET/CT imaging during therapy. There was a significant difference in 2-year OS between patients with negative iPET/CT and those with positive iPET/CT. Patients who had positive iPET/CT showed inferior 2-year PFS compared to those with negative iPET/CT. According to IPI, there was a statistically significant difference in 2-year OS and PFS between patients in the lower and higher risk groups. However, these patients can be further subdivided according to iPET/CT. The iPET/CT results in the present study clearly separate good- and poor-prognosis patients according to differences in 2-year OS, both in the lower and higher IPI risk groups. These results are in agreement with those of previous studies that demonstrated that iPET/CT has high negative predictive value, clearly identifying good-prognosis patients even within the poor-prognosis IPI group.

摘要

治疗 DLBCL 患者仍然是一个挑战,因为对一线免疫化疗的反应有些不可预测。国际预后指数(IPI)是评估预后最广泛使用的方法之一。治疗期间的中期 PET/CT(iPET/CT)可以在治疗结束检查之前及早识别“无应答”患者。在这项研究中,我们回顾性分析了 104 例接受 R-CHOP 样方案治疗的新诊断的 DLBCL 患者,这些患者在治疗期间接受了 iPET/CT 成像。阴性 iPET/CT 和阳性 iPET/CT 患者的 2 年 OS 存在显著差异。与阴性 iPET/CT 患者相比,阳性 iPET/CT 患者的 2 年 PFS 较差。根据 IPI,低危和高危组患者的 2 年 OS 和 PFS 存在统计学差异。然而,这些患者可以根据 iPET/CT 进一步细分。本研究的 iPET/CT 结果根据 2 年 OS 的差异,清楚地将低危和高危 IPI 风险组的患者分为预后良好和预后不良的患者。这些结果与之前的研究结果一致,表明 iPET/CT 具有较高的阴性预测值,即使在预后不良的 IPI 组内,也能清楚地识别预后良好的患者。

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