Journal
ANNALS OF HEMATOLOGY
Volume 91, Issue 5, Pages 697-703Publisher
SPRINGER
DOI: 10.1007/s00277-011-1357-2
Keywords
Diffuse large B cell lymphoma; Positron emission tomography; Rituximab
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Funding
- Ministry for Health, Welfare and Family affairs, Republic of Korea [0920050]
- Ministry of Health and Welfare, Republic of Korea [A070001]
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The objective of this study was to investigate whether metabolic tumor volume (MTV) by positron emission tomography (PET) can be a potential prognostic tool when compared with Ann Arbor stage, in stages II and III nodal diffuse large B cell lymphoma (DLBCL). We evaluated 169 patients with nodal stages II and III DLBCL who underwent measurements with PET prior to rituximab combined with cyclophosphamide, adriamycin, vincristine, and prednisone (R-CHOP). Cutoff point of MTV was measured using the receiver operating characteristic (ROC) curve. During a median period of 36 months, stage II was 59.2% and III was 40.8%. Using the ROC curve, the MTV of 220 cm(3) was the cutoff value. The low MTV group (< 220 cm(3)) had longer progression-free survival (PFS) and overall survival (OS), compared with the high MTV group (a parts per thousand yen220 cm(3)) (p < 0.001, p < 0.001). Stage II patients had longer survival than those in stage III (PFS, p = 0.011; OS, p = 0.001). The high MTV group had lower PFS and OS patterns, regardless of stage, compared with the low MTV group (p < 0.001, p < 0.001). Multivariate analysis revealed an association of the high MTV group with lower PFS and OS (PFS, hazard ratio (HR) = 5.300, p < 0.001; OS, HR = 7.009, p < 0.001), but not stage III (PFS, p = 0.187; OS, p = 0.054). Assessment of MTV by PET had more potential predictive power than Ann Arbor stage in the patients that received R-CHOP.
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