Herraez Ines, Bento Leyre, Daumal Jaume, Repetto Alessandra, Del Campo Raquel, Perez Sandra, Ramos Rafael, Ibarra Javier, Mestre Francesc, Bargay Joan, Lopez Paloma, Garcias-Ladaria Joan, Sampol Antonia, Gutierrez Antonio
Department of Hematology, Son Llatzer University Hospital, 07198 Palma de Mallorca, Spain.
Institut d'Investigació Sanitària Illes Balears (IdISBa), Son Espases University Hospital, 07120 Palma de Mallorca, Spain.
J Clin Med. 2021 Sep 26;10(19):4396. doi: 10.3390/jcm10194396.
Hodgkin lymphoma (HL) is a hematological malignancy with an excellent prognosis. However, we still need to identify those patients that could experience failed standard frontline chemotherapy. Tumor burden evaluation and standard decisions are based on Ann Arbor (AA) staging, but this approach may be insufficient in predicting outcomes. We aim to study new ways to assess tumor burden through volume-based PET parameters to improve the risk assessment of HL patients. We retrospectively analyzed 101 patients with HL from two hospitals in the Balearic Islands between 2011 and 2018. Higher metabolic tumor volume (MTV) and total lesion glycolysis (TLG) were significantly associated with a higher incidence of III-IV AA stages, B-symptoms, hypoalbuminemia, lymphopenia, and higher IPS. Standardized uptake value (SUVmax) was significantly related to AA stage and hypoalbuminemia. We found that TLG or the combination of SUVmax, TLG, and MTV significantly improved the risk assessment when compared to AA staging. We conclude that TLG is the best single PET/CT-related tumor-load parameter that significantly improves HL risk assessment when compared to AA staging. If confirmed in a larger and validated sample, this information could be used to modify standard frontline therapy and justifies the inclusion of TLG inside an HL prognostic score.
霍奇金淋巴瘤（HL）是一种预后良好的血液系统恶性肿瘤。然而，我们仍需识别那些可能对标准一线化疗反应不佳的患者。肿瘤负荷评估和标准决策基于Ann Arbor（AA）分期，但这种方法在预测预后方面可能并不充分。我们旨在研究通过基于体积的PET参数评估肿瘤负荷的新方法，以改善HL患者的风险评估。我们回顾性分析了2011年至2018年间来自巴利阿里群岛两家医院的101例HL患者。较高的代谢肿瘤体积（MTV）和总病变糖酵解（TLG）与III-IV期AA分期、B症状、低白蛋白血症、淋巴细胞减少症以及较高的国际预后评分（IPS）的发生率显著相关。标准化摄取值（SUVmax）与AA分期和低白蛋白血症显著相关。我们发现，与AA分期相比，TLG或SUVmax、TLG和MTV的组合显著改善了风险评估。我们得出结论，与AA分期相比，TLG是最佳的单一PET/CT相关肿瘤负荷参数，可显著改善HL风险评估。如果在更大且经过验证的样本中得到证实，该信息可用于修改标准一线治疗，并证明将TLG纳入HL预后评分是合理的。
