Saurabh Zanwar,Gokce Belge Bilgin,Stephen M Broski,Matthew Thorpe,Cem Bilgin,Wilson Gonsalves,Prashant Kapoor,Taxiarchis Kourelis,Suzanne Hayman,Nadine Abdallah,Moritz Binder,Joselle Cook,Angela Dispenzieri,David Dingli,Morie A Gertz,Nelson Leung,Yi Lin,Eli Muchtar,Rahma Warsame,Robert A Kyle,S Vincent Rajkumar,Shaji Kumar
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引用次数: 0
Abstract
Positron Emission Tomography (PET)-based assessments are an integral part of response assessment in patients with multiple myeloma (MM) with extramedullary disease (EMD), yet their utility in EMD remains to be systematically studied. We retrospectively evaluated 95 patients with EMD undergoing FDG PET/CT imaging for metabolic response assessment using visual Deauville Scores (DS) and total lesion glycolysis (TLG). TLG responses were categorized as complete metabolic response (CMR; 100% reduction), major metabolic response (MMR; <100% to ≥50% reduction), and non-significant metabolic response (NMR; <50% reduction). The median progression-free survival (PFS) differed significantly by DS (22.4 vs. 4.3 vs. 2.8 months for DS ≤ 3, =4, and =5, respectively; p < 0.0001) and by TLG response (36.5 vs. 5.4 vs. 2.2 months for CMR, MMR, NMR; p < 0.0001). TLG offered better discrimination than DS, with approximately one-third of patients in each DS stratum being reclassified by the TLG stratification. In a multivariable analysis, TLG response [HR 2.6 (95% CI: 1.8-3.8), p < 0.0001] remained independently prognostic after adjusting for cytogenetics, triple-class refractoriness, and de novo EMD status. The 18-month OS rates were 89%, 42% and 19% for the TLG CMR, MMR, and NMR cohorts (p < 0.001). These findings support the integration of TLG into response criteria for EMD.
期刊介绍:
Title: Leukemia
Journal Overview:
Publishes high-quality, peer-reviewed research
Covers all aspects of research and treatment of leukemia and allied diseases
Includes studies of normal hemopoiesis due to comparative relevance
Topics of Interest:
Oncogenes
Growth factors
Stem cells
Leukemia genomics
Cell cycle
Signal transduction
Molecular targets for therapy
And more
Content Types:
Original research articles
Reviews
Letters
Correspondence
Comments elaborating on significant advances and covering topical issues