Accuracy and prognostic impact of FDG PET/CT and biopsy in bone marrow assessment of follicular lymphoma at diagnosis : A Nation-Wide cohort study

Isabel Ródenas-Quiñonero, Tzu Chen-Liang, Taida Martín Santos, Antonio Salar, Marta Fernández-González, Carolina Celades, José-Tomás Navarro, Ana Belén Martínez-Garcia, Rafael Andreu, Aitana Balaguer, Alejandro Martín García-Sancho, Mónica Baile, Javier Lopez-Jimenez, Juan Marquet-Palomanes, Ana Isabel Teruel, Maria Jose Terol, Carmen Benet, Laura Frutos, José Luís Navarro, Jon Uña-GorospeMarina Suarez, Montserrat A. Cortés, José Contreras, Cristina Ruiz, Pilar Tamayo, Jorge Mucientes, Pablo Sopena-Novales, Laura Reguilón-Gallego, José Javier Sánchez-Blanco, Elena Pérez-Ceballos, Andrés Jerez, Francisco José Ortuño

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6 Cites (Scopus)

Resum

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.
Idioma originalAnglès
Pàgines (de-a)6536-6546
Nombre de pàgines11
RevistaCancer Medicine
Volum12
Número6
DOIs
Estat de la publicacióPublicada - 2023

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