Prognostic model for high-tumor-burden follicular lymphoma integrating baseline and end-induction PET: a LYSA/FIL study
Prognostic model for high-tumor-burden follicular lymphoma integrating baseline and end-induction PET: a LYSA/FIL study
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DOI：
10.1182/blood-2017-11-816298
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发表时间：
2018-05-31
期刊：
影响因子：
20.3
通讯作者：
Meignan, Michel
中科院分区：
文献类型：
--
作者：
Cottereau, Anne Segolene;Versari, Annibale;Meignan, Michel
在基线正电子发射断层扫描（PET）上计算的总代谢肿瘤体积（TMTV）和诱导结束（EOI） PET都是成像生物标志物，有望在高肿瘤负荷滤泡性淋巴瘤患者中进行早期风险分层。我们在来自3个前瞻性试验的159例患者中建立了包含这2个因素的模型：2个淋巴瘤研究协会（LYSA）研究和1个意大利林福米基金会（FIL）试验。中位随访为64个月。高TMTV （>510 cm(3)）和EOI PET阳性是独立的、显著的进展危险因素。他们的联合将人群分为3个危险组：无危险因素的患者（n= 102; 64%）的5年无进展生存率（PFS）为67% vs 33%（风险比[HR]， 2.9； 95%可信区间[CI]， 1.8-4.9），有1个危险因素的患者（n=44; 27%）只有23% (HR, 4.6； 95%可信区间[CI]， 2.3-9.2)，有两个危险因素的患者（n= 13; 8%）。2年PFS分别为90% vs 61% （HR, 4.8; 95% CI, 2.2-10.4）和46% （HR, 8.1; 95% CI, 3.1-21.3）。该模型增强了PET分期和反应评估的预后价值，确定了2年时进展和早期治疗失败风险极高的患者亚群。
Both total metabolic tumor volume (TMTV), computed on baseline positron emission tomography (PET), and end of induction (EOI) PET are imaging biomarkers showing promise for early risk stratification in patients with high-tumor-burden follicular lymphoma. A model was built incorporating these 2 factors in 159 patients from three prospective trials: 2 Lymphoma Study Association (LYSA) studies and 1 Fondazione Italiana Linfomi (FIL) trial. Median follow up was 64 months. High TMTV (>510 cm(3)) and positive EOI PET were independent, significant risk factors for progression. Their combination stratified the population into 3 risk groups: patients with no risk factors (n = 102; 64%) had a 5-year progression-free survival (PFS) of 67% vs 33% (hazard ratio [HR], 2.9; 95% confidence interval [CI], 1.8-4.9) for patients with 1 risk factor (n=44; 27%) and only 23% (HR, 4.6; 95% CI, 2.3-9.2) for patients with both risk factors (n 5 13; 8%). 2-year PFS was respectively 90% vs 61% (HR, 4.8; 95% CI, 2.2-10.4) and 46% (HR, 8.1; 95% CI, 3.1-21.3). This model enhances the prognostic value of PET staging and response assessment, identifying a subset of patients with a very high risk of progression and early treatment failure at 2 years.