预处理自体干细胞移植前 PET/CT 对弥漫性大 B 细胞淋巴瘤的预后价值：Deauville 评分优于 ΔSUVmax。
Prognostic Value of Pre-Autologous Stem Cell Transplantation PET/CT in Diffuse Large B-Cell Lymphoma: The Deauville Score Is Prognostically Superior to ΔSUVmax.
机构信息
Department of Hematology, Qingdao Central Hospital, Qingdao, China.
Department of Hematology, Qingdao Central Hospital, Qingdao, China,
出版信息
Acta Haematol. 2020;143(2):124-130. doi: 10.1159/000500512. Epub 2019 Aug 5.
OBJECTIVE
The predictive value of pre-autologous stem cell transplantation (pre-ASCT) positron emission tomography/computed tomography (PET/CT) scans according to different criteria remains elusive in patients with diffuse large B-cell lymphoma (DLBCL).
METHODS
A total of 46 DLBCL patients treated with pre-ASCT were enrolled in the present study, and two methods, Deauville score and maximal standardized uptake value reduction (ΔSUVmax), were used to evaluate the PET/CT scans before transplantation.
RESULTS
In patients with Deauville 1-3 and ≥4, the 2-year progression-free survival (PFS) rates were 82.8 and 11.8% (p < 0.001), respectively, while the 2-year overall survival (OS) rates were 89.7 and 41.2%, respectively (p < 0.001). When using the ΔSUVmax cut-off of 66% criterion, in patients with a ΔSUVmax of >66 and ≤66%, the 2-year PFS rates were 78.1 and 7.1%, respectively (p < 0.001), while the 2-year OS rates were 87.5 and 35.7%, respectively (p < 0.001). In the univariate analysis, the ΔSUVmax, Deauville score, NCCN-IPI and serum lactate dehydrogenase levels were significantly correlated with the 2-year PFS/OS. Furthermore, the multivariate analysis revealed that the Deauville score was an independent prognostic factor for 2-year PFS.
CONCLUSION
The present results indicate that PET/CT scans at pre-ASCT can predict the survival of DLBCL patients, and the Deauville score is better than ΔSUVmax in prognostic prediction.
目的
在弥漫性大 B 细胞淋巴瘤（DLBCL）患者中，根据不同标准，自体干细胞移植前（pre-ASCT）正电子发射断层扫描/计算机断层扫描（PET/CT）扫描的预测价值仍不明确。
方法
本研究共纳入 46 例接受 pre-ASCT 治疗的 DLBCL 患者，使用 Deauville 评分和最大标准化摄取值降低（ΔSUVmax）两种方法评估移植前的 PET/CT 扫描。
结果
在 Deauville 评分 1-3 和≥4 的患者中，2 年无进展生存率（PFS）分别为 82.8%和 11.8%（p<0.001），2 年总生存率（OS）分别为 89.7%和 41.2%（p<0.001）。当使用 ΔSUVmax 截断值为 66%标准时，在 ΔSUVmax>66%和≤66%的患者中，2 年 PFS 率分别为 78.1%和 7.1%（p<0.001），2 年 OS 率分别为 87.5%和 35.7%（p<0.001）。单因素分析显示，ΔSUVmax、Deauville 评分、NCCN-IPI 和血清乳酸脱氢酶水平与 2 年 PFS/OS 显著相关。此外，多因素分析显示，Deauville 评分是 2 年 PFS 的独立预后因素。
结论
本研究结果表明，pre-ASCT 的 PET/CT 扫描可以预测 DLBCL 患者的生存情况，且 Deauville 评分在预后预测方面优于 ΔSUVmax。
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