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Interim PET/CT-based prognostic model for the treatment of diffuse large B cell lymphoma in the post-rituximab era

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Abstract

The prognostic accuracy of interim 18F-fluoro-2-dexoy-d-glucose positron emission tomography/computerized tomography (PET/CT) using three different methods of response assessments during rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisolone chemotherapy was investigated in 186 patients with newly diagnosed diffuse large B cell lymphoma (DLBCL). The response of interim PET/CT was assessed based on a combined evaluation of the Deauville five-point scale (5-PS), the rates of reduction in the maximal standardized uptake value (ΔSUVmax), and the rates of reduction in the metabolic tumor volume (ΔMTV2.5). Positivity on the 5-PS, the optimal cutoff of ΔSUVmax, or the optimal cutoff of ΔMTV2.5 could each predict disease progression. Over a median follow-up of 22.8 months, the assessment of responses based on the 5-PS, ΔSUVmax, and ΔMTV2.5 had prognostic value for progression-free survival. When patients were allocated a score of 0 to 3 depending on the presence of an inadequate response by visual, ΔSUVmax, or ΔMTV2.5, the outcomes of patients with a score of 0 were significantly superior to those with a score of 1, 2, or 3. The interim PET/CT response based on visual, SUV-based, and MTV-based assessment had significant negative predictive value for disease progression and a high potential for predicting outcomes of patients with DLBCL.

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Acknowledgments

The authors thank Dr. Christian Bryant, Dendritic Cell Biology and Therapeutics at the ANZAC Research Institute, for revision of the manuscript.

Conflict of interest

The authors have declared no conflicts of interest.

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Authors and Affiliations

  1. Department of Hematology–Oncology, Chonnam National University Hwasun Hospital, 160 Ilsimri, Hwasun, Jeollanamdo, 519-809, Republic of Korea

    Deok-Hwan Yang, Jae-Sook Ahn, Sung-Hoon Jung, Yeo-Kyeoung Kim, Hyeoung-Joon Kim & Je-Jung Lee

  2. Department of Nuclear Medicine, Chonnam National University Hwasun Hospital, Hwasun, Jeollanamdo, Republic of Korea

    Byung Hyun Byun, Jung Joon Min & Hee-Seung Bom

  3. Department of Preventive Medicine, Chonnam National University Hwasun Hospital, Hwasun, Jeollanamdo, Republic of Korea

    Sun-Seog Kweon

  4. Department of Hematology/Oncology, Kyungpook National University Hospital, Daegu, Republic of Korea

    Yee Soo Chae & Sang Kyun Sohn

  5. Department of Nuclear Medicine, Kyungpook National University Hospital, Daegu, Republic of Korea

    Sang Woo Lee & Hae Won Kim

  6. The Brain Korea 21 Project, Center for Biomedical Human Resources at Chonnam National University, Gwangju, Republic of Korea

    Je-Jung Lee

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  1. Deok-Hwan Yang
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Correspondence to Je-Jung Lee.

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Yang, DH., Ahn, JS., Byun, B.H. et al. Interim PET/CT-based prognostic model for the treatment of diffuse large B cell lymphoma in the post-rituximab era. Ann Hematol 92, 471–479 (2013). https://doi.org/10.1007/s00277-012-1640-x

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  • DOI: https://doi.org/10.1007/s00277-012-1640-x

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