info:eu-repo/semantics/article
Identification of a patient cohort with relapsing diffuse large b-cell lymphoma with a low international prognostic index in pet/ct using a 2-gene (lmo2/tnfrsf9) scoring system
Fecha
2020-12Registro en:
Omidvar, Nader; Tekin, Nilgun; Conget, Paulette; Bruna, Flavia Alejandra; Timar, Botond; et al.; Identification of a patient cohort with relapsing diffuse large b-cell lymphoma with a low international prognostic index in pet/ct using a 2-gene (lmo2/tnfrsf9) scoring system; Karger; Acta Haematologica; 143; 6; 12-2020; 600-602
0001-5792
CONICET Digital
CONICET
Autor
Omidvar, Nader
Tekin, Nilgun
Conget, Paulette
Bruna, Flavia Alejandra
Timar, Botond
Gagyi, Eva
Basak, Ranjan
Auewarakul, Chirayu
Sritana, Narongrit
Cerci, Juliano Julio
DImamay, Mark Pierre
Gyorke, Tamas
Redondo, Francisca
Nair, Reena
Gorospe, Charity
Paez, DIana
Fanti, Stefano
Ozdag, Hilal
Padua, Rose Ann
Carr, Robert
Resumen
Treating patients with diffuse large Bcell lymphoma (DLBCL) remains a challenge, with a remission rate of 75% at 2 years from diagnosis. The International Prognostic Index (IPI) [1] and molecularcharacterization [2] are employed in the stratification and relapse prediction. Additionally, 18F-fluorodeoxyglucose positron emission tomography (PET) and computed tomography (CT) have now become part of standard care in differentiating metabolic activity of the disease from fibrosisor necrosis [3]. Early optimism that the speed of response to treatment, as indicated by an interim-PET (iPET) scan after 2?3 cycles of chemotherapy, might reliably predict cure has not been fulfilled [4].To investigate the role of both an interim and an end-treatment-PET (ePET) scan for the management of DLBCL in an international setting, at a time when PET centers were becoming established globally, the International Atomic Energy Agency (IAEA) sponsored a study across 7 countries in Europe, South Asia, Southeast Asia, and South America [5]. This study, the largest study to date, found that 34% of cases were iPET+ after 2 or 3 cycles of standard chemotherapy (R-CHOP), but 54% of the iPET+ cases became ePET?; and that these ?slow responders? had relatively good outcomes at 2 years (event-free survival, EFS: 86%). Notably, the study found that by combining a negative iPET scan with 2 clinical components of the IPI (normal LDH and good performance status), it was possible to identify a population, 35% of all cases, 98% of whom were disease free 2 years after diagnosis. By contrast, iPET+ cases that remained PET+ at the end of treatment had dismal outcomes. These findings raisethe important question of how to separate slow-responding iPET+ cases who are PET? at the end treatment, who are destined for good survival, from those who will fail to achieve a complete or stable remission by continuing standard therapy.