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Bone marrow biopsy superiority over PET/CT in predicting progression-free survival in a homogeneously-treated cohort of diffuse large B-cell lymphoma.
- Source :
-
Cancer medicine [Cancer Med] 2017 Nov; Vol. 6 (11), pp. 2507-2514. Date of Electronic Publication: 2017 Sep 27. - Publication Year :
- 2017
-
Abstract
- Several studies have reported uneven results when evaluating the prognostic value of bone marrow biopsy (BMB) and PET/CT as part of the staging of diffuse large B-cell lymphoma (DLBCL). The heterogeneity of the inclusion criteria and not taking into account selection and collinearity biases in the analysis models might explain part of these discrepancies. To address this issue we have carried a retrospective multicenter study including 268 DLBCL patients with a BMB and a PET/CT available at diagnosis where we estimated both the prognosis impact and the diagnostic accuracy of each technique. Only patients treated with R-CHOP/21 as first line (n = 203) were included in the survival analysis. With a median follow-up of 25 months the estimated 3-year progression-free survival (PFS) and overall survival (OS) were 76.3% and 82.7% respectively. In a multivariate analysis designed to avoid a collinearity bias with IPI categories, BMB-BMI [bone marrow involvement](+) (HR: 3.6) and ECOG PS > 1 (HR: 2.9) were independently associated with a shorter PFS and three factors, age >60 years old (HR: 2.4), ECOG PS >1 (HR: 2.4), and abnormally elevated B2-microglobulin levels (HR: 2.2) were independently associated with a shorter OS. In our DLBCL cohort, treated with a uniform first-line chemotherapy regimen, BMI by BMB complemented performance status in predicting those patients with a higher risk for relapse or progression. In this cohort BMI by PET/CT could not independently predict a shorter PFS and/or OS.<br /> (© 2017 The Authors. Cancer Medicine published by John Wiley & Sons Ltd.)
- Subjects :
- Adolescent
Adult
Age Factors
Aged
Aged, 80 and over
Antibodies, Monoclonal, Murine-Derived therapeutic use
Antineoplastic Combined Chemotherapy Protocols therapeutic use
Biopsy
Cyclophosphamide therapeutic use
Disease-Free Survival
Doxorubicin therapeutic use
Female
Follow-Up Studies
Health Status
Humans
Lymphoma, Large B-Cell, Diffuse drug therapy
Male
Middle Aged
Multivariate Analysis
Predictive Value of Tests
Prednisone therapeutic use
Retrospective Studies
Rituximab administration & dosage
Survival Rate
Vincristine therapeutic use
Young Adult
beta 2-Microglobulin blood
Bone Marrow diagnostic imaging
Bone Marrow pathology
Lymphoma, Large B-Cell, Diffuse diagnostic imaging
Lymphoma, Large B-Cell, Diffuse pathology
Positron Emission Tomography Computed Tomography
Subjects
Details
- Language :
- English
- ISSN :
- 2045-7634
- Volume :
- 6
- Issue :
- 11
- Database :
- MEDLINE
- Journal :
- Cancer medicine
- Publication Type :
- Academic Journal
- Accession number :
- 28960797
- Full Text :
- https://doi.org/10.1002/cam4.1205