Morland David, Kanagaratnam Lukshe, Hubelé Fabrice, Toussaint Elise, Choquet Sylvain, Kas Aurélie, Caquot Pierre-Ambroise, Haioun Corinne, Itti Emmanuel, Leprêtre Stéphane, Decazes Pierre, Bijou Fontanet, Schwartz Paul, Jacquet Caroline, Chauchet Adrien, Matuszak Julien, Kamar Nassim, Payoux Pierre, Durot Eric
Médecine Nucléaire, Institut Godinot, Reims, France.
Laboratoire de Biophysique, UFR de Médecine, Université de Reims Champagne-Ardenne, Reims, France.
EJNMMI Res. 2024 May 27;14(1):49. doi: 10.1186/s13550-024-01111-8.
Besides International Prognostic Index (IPI) score, baseline prognostic factors of post-transplant lymphoproliferative disorders (PTLD) are poorly identified due to the rarity of the disease. New indexes derived from healthy organ uptake in baseline 18F-FDG PET/CT have been studied in immunocompetent lymphoma patients. The aim of this study is to evaluate the performances of the cerebellum-to-liver uptake ratio (denoted as CLIP) as a prognostic factor for PFS and OS. This retrospective multicenter study is based on patients with PTLD included in the K-VIROGREF cohort. The previously published threshold of 3.24 was used for CLIP in these analyses.
A total of 97 patients was included with a majority of monomorphic diffuse large B-cell lymphoma subtype (78.3%). Both IPI score (≥ 3) and CLIP (< 3.24) were significant risk factors of PFS with corresponding hazard ratios of 2.0 (1.0-4.0) and 2.4 (1.3-4.5) respectively. For OS, CLIP was not significant and resulted in a hazard ratio of 2.6 (p = 0.059). Neither IPI score or Total Metabolic Tumor Volume reached significance for OS.
CLIP is a promising predictor of PFS and perhaps OS in PTLD. Further prospective studies are needed to confirm these results.
除国际预后指数（IPI）评分外，由于移植后淋巴组织增生性疾病（PTLD）罕见，其基线预后因素尚未明确。免疫功能正常的淋巴瘤患者中，已对基于基线18F-FDG PET/CT中健康器官摄取情况得出的新指标进行了研究。本研究旨在评估小脑与肝脏摄取比值（记为CLIP）作为无进展生存期（PFS）和总生存期（OS）预后因素的性能。这项回顾性多中心研究基于纳入K-VIROGREF队列的PTLD患者。这些分析中CLIP采用先前公布的3.24阈值。
共纳入97例患者，多数为单形性弥漫性大B细胞淋巴瘤亚型（78.3%）。IPI评分（≥3）和CLIP（<3.24）均为PFS的显著危险因素，相应的风险比分别为2.0（1.0 - 4.0）和2.4（1.3 - 4.5）。对于OS，CLIP不显著，风险比为2.6（p = 0.059）。IPI评分和总代谢肿瘤体积对OS均未达到显著水平。
CLIP是PTLD中PFS以及可能是OS的有前景的预测指标。需要进一步的前瞻性研究来证实这些结果。
