Standardization of 18F-FDG-PET/CT According to Deauville Criteria for Metabolic Complete Response Definition in Newly Diagnosed Multiple Myeloma
Standardization of 18F-FDG-PET/CT According to Deauville Criteria for Metabolic Complete Response Definition in Newly Diagnosed Multiple Myeloma
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DOI：
10.1200/jco.20.00386
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发表时间：
2021-01-10
影响因子：
45.3
通讯作者：
Kraeber-Bodere, Francoise
中科院分区：
文献类型：
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作者：
Zamagni, Elena;Nanni, Cristina;Kraeber-Bodere, Francoise
目的F-18-氟脱氧葡萄糖（FDG）正电子发射断层扫描（PET）/计算机断层扫描（CT）是目前确定多发性骨髓瘤（MM）患者骨髓（BM）外微小残留病（MRD）状态的标准技术。本研究旨在定义治疗后PET完全代谢反应的标准，联合分析两项独立的欧洲随机III期试验（IFM/DFCI 2009和EMN 02/HO 95）中入选的新诊断的符合移植条件的MM患者亚组。根据研究设计，在基线和开始维持治疗前（维持治疗前[PM]）进行PET/CT扫描。五点Deauville量表（DS）被应用于描述BM（BM评分[BMS]）和局灶性病变（FL; FL评分[FS]）摄取和测试后验在单变量和多变量分析其对临床outcome. RESULTS的影响，在基线时，78%的患者有FL（11%髓外），80%的FS >= 4。所有患者都有BM弥漫性摄取（35.5%，BMS >= 4）。在PM时，31%的患者可见FL（髓外2%），其中分别有24%和67.7%的FS为3和>= 4。在PM时，98%的患者保留了残余的BM弥漫性摄取，其显著低于基线（主要在BMS 2和3之间，仅8.7%的患者BMS>= 4）。通过单变量和多变量分析，FS和BMS，
PURPOSE F-18-Fluorodeoxyglucose (FDG) positron emission tomography (PET)/computed tomography (CT) is currently the standard technique to define minimal residual disease (MRD) status outside the bone marrow (BM) in patients with multiple myeloma (MM). This study aimed to define criteria for PET complete metabolic response after therapy, jointly analyzing a subgroup of newly diagnosed transplantation-eligible patients with MM enrolled in two independent European randomized phase III trials (IFM/DFCI2009 and EMN02/HO95).PATIENTS AND METHODS Two hundred twenty-eight patients were observed for a median of 62.9 months. By study design, PET/CT scans were performed at baseline and before starting maintenance (premaintenance [PM]). The five-point Deauville scale (DS) was applied to describe BM (BM score [BMS]) and focal lesion (FL; FL score [FS]) uptake and tested a posteriori in uni- and multivariable analyses for their impact on clinical outcomes.RESULTS At baseline, 78% of patients had FLs (11% extramedullary), 80% with an FS >= 4. All patients had BM diffuse uptake (35.5% with BMS >= 4). At PM, 31% of patients had visually detectable FLs (2% extramedullary), 24% and 67.7% of them with an FS of 3 and >= 4, respectively. At PM, 98% of patients retained residual BM diffuse uptake, which was significantly lower than at baseline (mainly between BMS 2 and 3, BMS was >= 4 in only 8.7% of patients). By both uni- and multivariable analysis, FS and BMS,