弥漫性大 B 细胞淋巴瘤患者基线氟代脱氧葡萄糖正电子发射断层扫描总代谢肿瘤体积的预后价值。
Prognostic Value of Baseline Total Metabolic Tumor Volume Measured on FDG PET in Patients With Richter Syndrome.
机构信息
From the Departments of Nuclear Medicine.
Medical Information, CLCC Eugène Marquis.
出版信息
Clin Nucl Med. 2020 Feb;45(2):118-122. doi: 10.1097/RLU.0000000000002879.
PURPOSE
We evaluated the prognostic value of baseline total metabolic tumor volume (TMTV) measured using pretreatment FDG PET for patients with transformation of chronic lymphocytic leukemia (CLL) into diffuse large B-cell lymphoma (DLBCL).
METHODS
A total of 28 patients with transformation of CLL into DLBCL who had undergone FDG PET before treatment were retrospectively reviewed. Univariate and multivariate analysis of conventional clinicopathologic variables (sex, age, World Health Organization performance status score, International Prognostic Index score, Binet stage, lactate dehydrogenase serum level [LDH], platelet count, presence or not of prior therapies for CLL, the time from CLL to Richter syndrome, Ann Arbor stage, Bulky or not) and metabolic parameters (SUVmax, SUVmean, TMTV, and total lesion glycolysis) at the time of the transformation of CLL into DLBCL were tested for overall survival (OS).
RESULTS
Of the 28 patients, 14 patients (50%) died during the follow-up period. Low platelet count, World Health Organization performance status score >1, high LDH, and high TMTV were found to be significant prognostic factors for OS on univariate analysis. The 5-year estimates of OS were 63% in the low metabolic burden group (TMTV ≤1200 cm) and 0% in the high metabolic burden group (TMTV >1200 cm). Multivariate analysis revealed that only high LDH was a significant predictor after adjustment for other variables of OS.
CONCLUSIONS
TMTV extracted from FDG PET at the time of the transformation of CLL into DLBCL is a predictor of OS.
目的
我们评估了使用 FDG PET 治疗前测量的基线总代谢肿瘤体积（TMTV）对慢性淋巴细胞白血病（CLL）转化为弥漫性大 B 细胞淋巴瘤（DLBCL）患者的预后价值。
方法
回顾性分析了 28 例经 FDG PET 治疗前转化为 DLBCL 的 CLL 患者。对传统临床病理变量（性别、年龄、世界卫生组织表现状态评分、国际预后指数评分、Binet 分期、乳酸脱氢酶血清水平[LDH]、血小板计数、CLL 治疗前是否存在、从 CLL 到里希特综合征的时间、安阿伯分期、是否为大块病变）和代谢参数（SUVmax、SUVmean、TMTV 和总病变糖酵解）进行单因素和多因素分析，以评估总体生存率（OS）。
结果
在 28 例患者中，有 14 例（50%）在随访期间死亡。单因素分析发现，低血小板计数、世界卫生组织表现状态评分>1、高 LDH 和高 TMTV 是 OS 的显著预后因素。低代谢负担组（TMTV≤1200cm）的 5 年 OS 估计为 63%，而高代谢负担组（TMTV>1200cm）的 OS 为 0%。多因素分析显示，在调整其他 OS 变量后，仅高 LDH 是显著的预测因子。
结论
在 CLL 转化为 DLBCL 时从 FDG PET 提取的 TMTV 是 OS 的预测因子。
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