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FDG PET/CT 对造血干细胞移植前后 T 淋巴母细胞淋巴瘤的预后价值。

Prognostic value of F-FDG PET/CT in T-Lymphoblastic lymphoma before and after hematopoietic stem cell transplantation.

机构信息

Department of Nuclear Medicine, Shanghai General Hospital, Shanghai JiaoTong University School of Medicine, Shanghai, 200080, China.

Department of Nuclear Medicine, General Hospital of Ningxia Medical University, Yinchuan, 750004, Ningxia, China.

出版信息

Clin Transl Oncol. 2021 Aug;23(8):1571-1576. doi: 10.1007/s12094-021-02551-7. Epub 2021 Jan 15.

Abstract

PURPOSE

We aimed to evaluate the prognostic value of F-FDG PET/CT in patients with relapsed or refractory T-Lymphoblastic lymphoma (T-LBL) undergoing hematopoietic stem cell transplantation (HSCT).

METHODS

PET/CT was performed in 21 consecutive relapsed or refractory T-LBL patients scheduled for HSCT. All PET/CT images were assessed using the Deauville criteria, and patients were divided into negative (Deauville ≤ 3) and positive (Deauville > 3) groups for comparison. The predictive value of sex, age, Ann Arbor stage, presence of B symptoms, lactate dehydrogenase level, presence of extranodal disease, and PET/CT results before and after HSCT were evaluated.

RESULTS

Kaplan-Meier analysis showed that only PET/CT after HSCT (post-PET) was correlated with progression-free survival (PFS) (P = 0.030). The Cox regression model also showed that the post-PET-positive group had a higher hazard ratio (HR) than the negative group (HR = 3.884 and P = 0.049). However, none of the evaluated factors were predictive of overall survival (OS).

CONCLUSIONS

Pre-PET cannot predict the PFS and OS of patients with T-LBL undergoing HSCT, which means that F-FDG PET/CT cannot be used for identifying patients who can benefit from HSCT. Post-PET is not predictive for OS in patients with T-LBL undergoing HSCT. However, post-PET showed strong correlations with PFS, which means that it may be useful for guiding subsequent clinical treatment decisions.

摘要

目的

我们旨在评估氟代脱氧葡萄糖正电子发射断层扫描/计算机断层扫描(F-FDG PET/CT)在接受造血干细胞移植(HSCT)的复发或难治性 T 淋巴细胞白血病(T-LBL)患者中的预后价值。

方法

对 21 例计划接受 HSCT 的复发或难治性 T-LBL 患者进行了 PET/CT 检查。所有 PET/CT 图像均采用 Deauville 标准进行评估,并将患者分为阴性(Deauville≤3)和阳性(Deauville>3)两组进行比较。评估了性别、年龄、Ann Arbor 分期、B 症状、乳酸脱氢酶水平、结外疾病的存在以及 HSCT 前后 PET/CT 结果的预测价值。

结果

Kaplan-Meier 分析表明,只有 HSCT 后的 PET/CT(后-PET)与无进展生存期(PFS)相关(P=0.030)。Cox 回归模型还显示,后-PET 阳性组的危险比(HR)高于阴性组(HR=3.884,P=0.049)。然而,没有一个评估因素对总生存期(OS)有预测作用。

结论

在接受 HSCT 的 T-LBL 患者中,前-PET 不能预测 PFS 和 OS,这意味着 F-FDG PET/CT 不能用于识别可从 HSCT 中获益的患者。后-PET 对接受 HSCT 的 T-LBL 患者的 OS 无预测作用。然而,后-PET 与 PFS 有很强的相关性,这意味着它可能有助于指导后续的临床治疗决策。

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