Treatment to suppression of focal lesions on positron emission tomography-computed tomography is a therapeutic goal in newly diagnosed multiple myeloma
Treatment to suppression of focal lesions on positron emission tomography-computed tomography is a therapeutic goal in newly diagnosed multiple myeloma
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DOI：
10.3324/haematol.2017.177139
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发表时间：
2018-06-03
期刊：
影响因子：
10.1
通讯作者：
Morgan, Gareth J.
中科院分区：
文献类型：
--
作者：
Davies, Faith E.;Rosenthal, Adam;Morgan, Gareth J.
骨髓瘤的18F-脱氧葡萄糖正电子发射断层扫描结合计算机断层扫描衰减校正(PET-CT)可以通过代谢活动的定量特征来发现和计数局灶性病变。这项研究的目的是确定在治疗开始后的几个时间点：第7天、诱导后、移植后和维持治疗时PET-CT活性抑制的预后意义。作为TT4-6试验系列的一部分，596名患者接受了基线PET-CT检查，并在他们的病程中使用高于背景红骨髓信号的标准化峰值摄取值进行了连续评估。我们证明，在出现3个以上局灶性病变时，确定了一组患者的不良进展无进展存活率和总存活率。在治疗第7天，局灶性病变信号完全抑制的患者恢复到与诊断时没有病变的患者相同的预后。在以后的时间点上，信号的持续抑制仍然具有预测意义。我们的结论是，对于新诊断的有局灶性病变的患者，治疗直到这些病变被抑制是一个重要的治疗目标，因为这些患者的预后与诊断时没有病变的患者是相同的。(ClinicalTrials.gov标识：00734877、02128230、00869232、00871013)。
Fluorine-18 fluorodeoxyglucose positron emission tomography with computed tomography attenuation correction (PET-CT) in myeloma can detect and enumerate focal lesions by the quantitative characterization of metabolic activity. The aim of this study was to determine the prognostic significance of the suppression of PET-CT activity at a number of time points post therapy initiation: day 7, post induction, post transplant, and at maintenance therapy. As part of the TT4-6 trial series, 596 patients underwent baseline PET-CT and were evaluated serially during their disease course using peak standardized uptake values above background red marrow signal. We demonstrate that the presence of more than 3 focal lesions at presentation identifies a group of patients with an adverse progression-free survival and overall survival. At day 7 of therapy, patients with complete focal lesion signal suppression revert to the same prognosis as those with no lesions at diagnosis. At later time points, the continued suppression of signal remains prognostically important. We conclude that for newly diagnosed patients with focal lesions, treatment until these lesions are suppressed is an important therapeutic goal as the prognosis of these patients is the same as those without lesions at diagnosis. (clinicaltrials.gov identifiers: 00734877, 02128230, 00869232, 00871013).