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Prognostic relevance of 18-F FDG PET/CT in newly diagnosed multiple myeloma patients treated with up-front autologous transplantation.
- Source :
-
Blood [Blood] 2011 Dec 01; Vol. 118 (23), pp. 5989-95. Date of Electronic Publication: 2011 Sep 06. - Publication Year :
- 2011
-
Abstract
- We prospectively analyzed the prognostic relevance of positron emission tomography-computed tomography (PET/CT) at diagnosis, after thalidomide-dexamethasone (TD) induction therapy and double autotransplantation (ASCT) in 192 newly diagnosed multiple myeloma (MM) patients. Presence at baseline of at least 3 focal lesions (FLs; 44% of cases), a standardized uptake value (SUV) > 4.2 (46%), and extramedullary disease (EMD; 6%) adversely affected 4-year estimates of progression-free survival (PFS; ≥ 3 FLs: 50%; SUV > 4.2: 43%; presence of EMD: 28%). SUV > 4.2 and EMD were also correlated with shorter overall survival (OS; 4-year rates: 77% and 66%, respectively). Persistence of SUV > 4.2 after TD induction was an early predictor for shorter PFS. Three months after ASCT, PET/CT was negative in 65% of patients whose 4-year rates of PFS and OS were superior to those of PET-positive patients (PFS: 66% and OS: 89%). In a multivariate analysis, both EMD and SUV > 4.2 at baseline and persistence of fluorodeoxyglucose (FDG) uptake after ASCT were independent variables adversely affecting PFS. PET/CT involvement at diagnosis, after novel agent-based induction and subsequent ASCT is a reliable predictor of prognosis in MM patients. This study is registered at www.clinicaltrials.gov as NTC01341262.
- Subjects :
- Adult
Aged
Aged, 80 and over
Dexamethasone therapeutic use
Glucocorticoids therapeutic use
Humans
Immunosuppressive Agents therapeutic use
Middle Aged
Predictive Value of Tests
Prognosis
Prospective Studies
Radiopharmaceuticals
Survival Rate
Thalidomide therapeutic use
Transplantation, Autologous
Fluorodeoxyglucose F18
Hematopoietic Stem Cell Transplantation methods
Multimodal Imaging methods
Multiple Myeloma diagnostic imaging
Multiple Myeloma therapy
Positron-Emission Tomography
Tomography, X-Ray Computed
Subjects
Details
- Language :
- English
- ISSN :
- 1528-0020
- Volume :
- 118
- Issue :
- 23
- Database :
- MEDLINE
- Journal :
- Blood
- Publication Type :
- Academic Journal
- Accession number :
- 21900189
- Full Text :
- https://doi.org/10.1182/blood-2011-06-361386