TY - JOUR
T1 - Accuracy and prognostic impact of FDG PET/CT and biopsy in bone marrow assessment of follicular lymphoma at diagnosis :
T2 - A Nation-Wide cohort study
AU - Ródenas-Quiñonero, Isabel
AU - Chen-Liang, Tzu
AU - Martín Santos, Taida
AU - Salar, Antonio
AU - Fernández-González, Marta
AU - Celades, Carolina
AU - Navarro, José-Tomás
AU - Martínez-Garcia, Ana Belén
AU - Andreu, Rafael
AU - Balaguer, Aitana
AU - Martín García-Sancho, Alejandro
AU - Baile, Mónica
AU - Lopez-Jimenez, Javier
AU - Marquet-Palomanes, Juan
AU - Teruel, Ana Isabel
AU - Terol, Maria Jose
AU - Benet, Carmen
AU - Frutos, Laura
AU - Navarro, José Luís
AU - Uña-Gorospe, Jon
AU - Suarez, Marina
AU - Cortés, Montserrat A.
AU - Contreras, José
AU - Ruiz, Cristina
AU - Tamayo, Pilar
AU - Mucientes, Jorge
AU - Sopena-Novales, Pablo
AU - Reguilón-Gallego, Laura
AU - Sánchez-Blanco, José Javier
AU - Pérez-Ceballos, Elena
AU - Jerez, Andrés
AU - Ortuño, Francisco José
PY - 2023
Y1 - 2023
N2 - Backgound: In the workup of follicular lymphoma (FL), bone marrow biopsy (BMB) assessment is a key component of FLIPI and FLIPI2, the most widely used outcome scores. During the previous decade, several studies explored the role of FDG-PET/CT for detecting nodal and extranodal disease, with only one large study comparing both techniques. Methods: The aim of our study was to evaluate the diagnostic accuracy and the prognostic impact of both procedures in a retrospective cohort of 299 FL patients with both tests performed at diagnosis. In order to avoid a collinearity bias, FLIPI2 was deconstructed in its founding parameters, and the bone marrow involvement (BMI) parameter separately included as: a positive BMB, a positive PET/CT, the combined "PET/CT and BMB positive" or "PET/CT or BMB positive". These variables were also confronted independently with the POD24 in 233 patients treated with intensive regimens. Results: In the total cohort, bone marrow was involved in 124 and 60 patients by BMB and PET/CT, respectively. In terms of overall survival, age > 60 y.o. and the combined "PET/CT or BMB positive" achieved statistical independence as a prognostic factor. In patients treated with an intensive regimen, only the combined "PET/CT or BMB positive" added prognostic value for a shorter overall survival, when confronted with the POD24. Conclusion: Our results show that in FL both BMB and PET/CT should be considered at diagnosis, as their combined assessment provides independent prognostic value in the context of the most widely use clinical scores.
AB - Backgound: In the workup of follicular lymphoma (FL), bone marrow biopsy (BMB) assessment is a key component of FLIPI and FLIPI2, the most widely used outcome scores. During the previous decade, several studies explored the role of FDG-PET/CT for detecting nodal and extranodal disease, with only one large study comparing both techniques. Methods: The aim of our study was to evaluate the diagnostic accuracy and the prognostic impact of both procedures in a retrospective cohort of 299 FL patients with both tests performed at diagnosis. In order to avoid a collinearity bias, FLIPI2 was deconstructed in its founding parameters, and the bone marrow involvement (BMI) parameter separately included as: a positive BMB, a positive PET/CT, the combined "PET/CT and BMB positive" or "PET/CT or BMB positive". These variables were also confronted independently with the POD24 in 233 patients treated with intensive regimens. Results: In the total cohort, bone marrow was involved in 124 and 60 patients by BMB and PET/CT, respectively. In terms of overall survival, age > 60 y.o. and the combined "PET/CT or BMB positive" achieved statistical independence as a prognostic factor. In patients treated with an intensive regimen, only the combined "PET/CT or BMB positive" added prognostic value for a shorter overall survival, when confronted with the POD24. Conclusion: Our results show that in FL both BMB and PET/CT should be considered at diagnosis, as their combined assessment provides independent prognostic value in the context of the most widely use clinical scores.
KW - Bone marrow biopsy
KW - Follicular lymphoma
KW - PET/CT
U2 - 10.1002/cam4.5424
DO - 10.1002/cam4.5424
M3 - Article
C2 - 36373169
SN - 2045-7634
VL - 12
SP - 6536
EP - 6546
JO - Cancer Medicine
JF - Cancer Medicine
IS - 6
ER -