The ratio of brain to liver glucose activity and disease activity in multiple myeloma

IF 12.9 1区医学 Q1 HEMATOLOGY

Blood Cancer Journal Pub Date : 2025-05-07 DOI:10.1038/s41408-025-01280-2

Sarah Dingli, Paul Rothweiler, Moritz Binder, Joselle Cook, Morie A. Gertz, Suzanne Hayman, Prashant Kapoor, Taxiarchis Kourelis, Shaji K. Kumar, Mustaqeem Siddiqui, Rahma Warsame, Yi Lin, Arthur G. Erdman, David Dingli

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Abstract

Changes in metabolic activity in tumor cells is one of the hallmarks of cancer. Cancer cells exhibit the Warburg effect with high glucose consumption for their energy needs. This provides the basis for imaging using ¹⁸F-2-deoxy-D-glucose for positron emission tomography to assess tumor burden and response to therapy. We postulated that metabolically active tumors may compete with the brain for glucose uptake and evaluated glucose uptake in the brain and liver in patients with multiple myeloma in various states of response and relapse. The ratio of brain to liver glucose activity (B2LR) mirrors disease activity in myeloma, predicts the presence of extramedullary disease and is also predictive of a short response to chimeric antigen receptor T cell therapy. Patients with a low B2LR also have an inferior survival compared to patients with persistently higher B2LR values. Our simple metabolic ratio has prognostic implications in myeloma and other tumors.

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多发性骨髓瘤患者脑与肝葡萄糖活性的比值及疾病活动性

肿瘤细胞代谢活动的变化是癌症的标志之一。癌细胞表现出高葡萄糖消耗以满足其能量需求的Warburg效应。这为使用18f -2-脱氧-d -葡萄糖进行正电子发射断层成像以评估肿瘤负荷和对治疗的反应提供了基础。我们假设代谢活跃的肿瘤可能与大脑竞争葡萄糖摄取，并评估了多发性骨髓瘤患者在不同反应和复发状态下大脑和肝脏的葡萄糖摄取。脑与肝葡萄糖活性的比值（B2LR）反映了骨髓瘤的疾病活性，预测髓外疾病的存在，也预测了嵌合抗原受体T细胞治疗的短期反应。与B2LR值持续较高的患者相比，B2LR值较低的患者生存率较低。我们的简单代谢率在骨髓瘤和其他肿瘤中具有预后意义。

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来源期刊

Blood Cancer Journal ONCOLOGY-

CiteScore

16.70

自引率

2.30%

发文量

153

审稿时长

>12 weeks

期刊介绍： Blood Cancer Journal is dedicated to publishing high-quality articles related to hematologic malignancies and related disorders. The journal welcomes submissions of original research, reviews, guidelines, and letters that are deemed to have a significant impact in the field. While the journal covers a wide range of topics, it particularly focuses on areas such as: Preclinical studies of new compounds, especially those that provide mechanistic insights Clinical trials and observations Reviews related to new drugs and current management of hematologic malignancies Novel observations related to new mutations, molecular pathways, and tumor genomics Blood Cancer Journal offers a forum for expedited publication of novel observations regarding new mutations or altered pathways.