Bilan initial, facteurs pronostiques et évaluation de la réponse thérapeutique des lymphomes

Abstract

Over the past two decades, FDG-PET has transformed the management of lymphomas, significantly enhancing staging and prognostic assessment, particularly with the adoption of the Lugano recommendations (2014). Now widely used for Hodgkin's lymphoma, DLBCL, and other FDG-avid lymphomas, PET has largely replaced the need for routine bone marrow biopsies. Intermediate PET (iPET) has proven to be a valuable tool for predicting outcomes, playing a crucial role in guiding patient stratification and treatment modifications, especially in Hodgkin's lymphoma and DLBCL. However, its early use in other types of lymphoma still requires further clinical validation. For follicular and mantle cell lymphomas, PET has shown promise in assessing treatment response, although the criteria for evaluating response need to be optimized. PET's integration into personalized treatment strategies enables more effective disease control while minimizing treatment-related toxicity.