Porrazzo Marika, Nicolai Emanuele, Riminucci Mara, Vitale Candida, Coscia Marta, De Paoli Lorenzo, Rago Angela, Buscicchio Giulia, Maestrini Giacomo, Ligia Silvio, Di Prima Alessio, Corsi Alessandro, Caronna Roberto, Gaidano Gianluca, Mauro Francesca Romana
Hematology, Department of Translational and Precision Medicine, Sapienza University, Via Benevento 6, 00161 Rome, Italy.
Institute of Diagnostic and Nuclear Research, IRCCS SDN, 80143 Naples, Italy.
Cancers (Basel). 2020 Jul 3;12(7):1773. doi: 10.3390/cancers12071773.
The role of positron emission tomography/computed tomography (PET/CT) in identifying Richter Syndrome (RS) is well established, while its impact on the survival of patients with chronic lymphocytic leukemia (CLL) has been less explored. The clinical characteristics and PET/CT data of 40 patients with a biopsy-proven CLL who required frontline chemoimmunotherapy, FCR (fludarabine, cyclophosphamide, rituximab) in 20 patients, BR (bendamustine, rituximab) in 20, were retrospectively analyzed. Standardized uptake volume (SUV) values ≥ 5 were observed more frequently in patients with deletion 11q ( = 0.006) and biopsies characterized by a rate of Ki67 positive cells ≥ 30% ( = 0.02). In the multivariate analysis, the presence of large and confluent PCs emerged as the only factor with a negative impact on progression-free survival (PFS), and overall survival (OS). Deletion 11q also revealed a significant and independent effect on PFS. SUV values ≥ 5 showed no statistical impact on PFS while in multivariate analysis, they revealed a significant adverse impact on OS (median survival probability not reached vs. 56 months; = 0.002). Moreover, patients with higher SUV values more frequently developed Richter Syndrome ( = 0.015). Our results show that higher SUV values identify CLL patients with a pronounced rate of proliferating cells in the lymph-node compartment, inferior survival, and an increased risk of developing RS.
正电子发射断层扫描/计算机断层扫描（PET/CT）在识别里氏综合征（RS）中的作用已得到充分证实，而其对慢性淋巴细胞白血病（CLL）患者生存的影响尚未得到充分研究。对40例经活检证实为CLL且需要一线化疗免疫治疗的患者的临床特征和PET/CT数据进行了回顾性分析，其中20例患者接受氟达拉滨、环磷酰胺、利妥昔单抗（FCR）治疗，20例患者接受苯达莫司汀、利妥昔单抗（BR）治疗。在11q缺失的患者（P = 0.006）和以Ki67阳性细胞率≥30%为特征的活检患者（P = 0.02）中，标准化摄取值（SUV）≥5更为常见。在多变量分析中，大的融合性增殖中心的存在是对无进展生存期（PFS）和总生存期（OS）产生负面影响的唯一因素。11q缺失对PFS也显示出显著的独立影响。SUV值≥5对PFS没有统计学影响，而在多变量分析中，它们对OS显示出显著的不利影响（中位生存概率未达到vs. 56个月；P = 0.002）。此外，SUV值较高的患者更频繁地发生里氏综合征（P = 0.015）。我们的结果表明，较高的SUV值可识别出淋巴结区增殖细胞率高、生存期较差且发生RS风险增加的CLL患者。
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