Impact of baseline and interim quantitative PET parameters on outcomes of classical Hodgkin Lymphoma

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Citações na Scopus
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Tipo de produção
article
Data de publicação
2024
DOI
Scopus
Web of Science
PubMed
Dimensions
Título da Revista
ISSN da Revista
Título do Volume
Editora
SPRINGER
Autores
MOREIRA, Frederico R.
Citação
ANNALS OF HEMATOLOGY, v.103, n.1, p.175-183, 2024
Projetos de Pesquisa
Unidades Organizacionais
Fascículo
Resumo
Currently, analysis of interim PET (iPET) according to the Deauville score (DS) is the most important predictive factor in Hodgkin lymphoma (HL); however, there is room for improvement in its prognostic power. This study aimed to evaluate the prognostic value of quantitative PET analysis (maximum standard uptake value [SUVmax], total metabolic tumor volume [TMTV] and total lesion glicolysis [TLG]) at baseline (PET0) and iPET in a retrospective cohort of newly diagnosed classical HL. For positive iPET (+ iPET), the reduction of quantitative parameters in relation to PET0 (Delta SUVmax, Delta TMTV and Delta TLG) was calculated. Between 2011 and 2017, 234 patients treated with ABVD were analyzed. Median age was 30 years-old, 59% had advanced stage disease, 57% a bulky mass and 25% a + iPET (DS 4-5). At baseline, high TLG was associated with an increased cumulative incidence of failure (CIF) (p = 0.032) while neither SUVmax, TMTV or TLG were associated with overall survival (OS) or progression-free survival (PFS). In multivariate analysis, only iPET was associated with CIF (p < 0.001). Among Delta SUVmax, Delta TMTV and Delta TLG, only a Delta SUVmax >= 68.8 was significant for PFS (HR: 0.31, CI95%: 0.11-0.86, p = 0.024). A subset of patients with improved PFS amongst + iPET was identified by the quantitative (Delta SUVmax >= 68.8%) analysis. In this real-world Brazilian cohort, with prevalent high-risk patients, quantitative analysis of PET0 did not demonstrate to be prognostic, while a dynamic approach incorporating the Delta SUV(max )to + iPET succeeded in refining a subset with better prognosis. These findings warrant validation in larger series and indicate that not all patients with + iPET might need treatment intensification.
Palavras-chave
Hodgkin lymphoma, Positron emission tomography, Metabolic tumor volume, Total lesion glycolysis
URI
https://observatorio.fm.usp.br/handle/OPI/58845
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Coleções
Artigos e Materiais de Revistas Científicas - FM/MDR