Back to Search Start Over

Prognostic relevance of 18-F FDG PET/CT in newly diagnosed multiple myeloma patients treated with up-front autologous transplantation.

Authors :
Zamagni E
Patriarca F
Nanni C
Zannetti B
Englaro E
Pezzi A
Tacchetti P
Buttignol S
Perrone G
Brioli A
Pantani L
Terragna C
Carobolante F
Baccarani M
Fanin R
Fanti S
Cavo M
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.

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