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Oncology-Clinical Diagnosis: Hematologic TumorsClinical Diagnosis: Hematologic Tumors Posters |
1 Nuclear Medicine & Radiology; 2 Hematology, H. Mondor AP-HP/Paris 12 Univ., Creteil, France
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Objectives: To determine whether the calculation of SUVmax reduction on early FDG-PET, at 2 cycles of induction chemotherapy, is an independent prognostic indicator compared to the International Prognostic Index (IPI), adjuvant treatment with Rituximab and consolidation by autologous stem cell transplantation (ASCT) in DLBCL.
Methods: FDG-PET was performed before chemotherapy onset (PET0) and after 2 cycles (PET2) in a prospective cohort of 92 patients (pts) with a newly-diagnosed DLBCL and followed-up for a median period of 42 mo. Treatment consisted of an anthracyclin-based regimen in all pts, with or without Rituximab, and was followed in the young higher-risk pts by an ASCT. Such heterogeneity was due to the evolution of treatment regimens over the 5-y inclusion period. We have recently shown that pts with a >65.7% SUVmax reduction from PET0 to PET2 had a significantly higher 2-y event-free survival (EFS) than those with a 
65.7% reduction (P<0.0001). The prognostic value of this cut-off was evaluated using Kaplan-Meier analysis and Logrank test.
Results: 38 pts (41%) had a low IPI score (<3), 47 (51%) had Rituximab, and 35 (38%) underwent an ASCT. Probability of EFS was significantly higher in the group of pts with >65.7% SUVmax reduction than in the one with 65.7% reduction under all circumstances : pts with low IPI (P=0.0001) or high IPI scores (P<0.0001) ; pts with Rituximab (P=0.02) or without Rituximab (P<0.0001) ; pts with ASCT (P<0.0001) or without ASCT (P=0.0001).
Conclusions: A >65.7% SUVmax reduction early during induction therapy remains an independent prognostic indicator with respect to the IPI score and different treatment approaches.
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