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Limited role of interim PET/CT in patients with diffuse large B-cell lymphoma treated with R-CHOP

Limited role of interim PET/CT in patients with diffuse large B-cell lymphoma treated with R-CHOP,10.1007/s00277-010-1135-6,Annals of Hematology,Chang

Limited role of interim PET/CT in patients with diffuse large B-cell lymphoma treated with R-CHOP  
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Positron emission tomography (PET) has been found useful in monitoring response to treatment of malignant lymphoma. We investigated the ability of interim PET to monitor response to standard dose R-CHOP chemotherapy in chemotherapy-naïve patients with diffuse large B-cell lymphoma (DLBCL). Between March 2004 and April 2009, 155 DLBCL patients treated with R-CHOP and available for interim and post-treatment PET/CT were identified and included in this analysis. Response, progression-free survival (PFS), and overall survival (OS) were compared between interim PET/CT-negative and positive group, and among three patient groups which were categorized based on their interim and post-treatment PET/CT: those with early metabolic complete response (mCR), delayed mCR, and never mCR. Interim PET/CT-negative patients (n = 100) showed superior CR rates to interim PET/CT-positive patients (n = 55; 93% vs 62%, P P = 0.07) and OS (P = 0.24) between interim PET/CT-negative and positive group. We categorized patients into three groups, with 100 (64%) in the early mCR group, 35 (23%) in the delayed mCR group, and 20 (13%) in the never mCR group. Early mCR and delayed mCR group did not differ significantly in PFS (P = 0.84) or OS (P = 0.20). However, the survival outcome in the never mCR group was significantly inferior to the combined early and delayed mCR group. The result from this study suggests that interim PET/CT might be an inappropriate tool for designing risk-adaptive therapy in chemotherapy-naïve DLBCL patients treated with R-CHOP. Prospective trials should be performed to clearly determine the role of interim PET/CT.
Journal: Annals of Hematology - ANN HEMATOL , vol. 90, no. 7, pp. 797-802, 2011
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