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Original Article

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Blood Res 2015; 50(2):

Published online June 25, 2015

https://doi.org/10.5045/br.2015.50.2.97

© The Korean Society of Hematology

Maximum standardized uptake value on positron emission tomography/computed tomography predicts clinical outcome in patients with relapsed or refractory diffuse large B-cell lymphoma

Hee Ryeong Jang1, Moo Kon Song2, Joo Seop Chung2*, Deok Hwan Yang3, Jeong Ok Lee4, Junshik Hong5, Su Hee Cho6, Seong Jang Kim7, Dong Hoon Shin8, Young Joo Park1, Jin-Suk Kang1, Jeong Eun Lee1, Moon Won Lee1, and Ho-Jin Shin2

Author Info. +

1Department of Internal Medicine, Pusan National University Hospital, Busan, Korea.

2Department of Hematology-Oncology, Pusan National University Hospital, Busan, Korea.

3Department of Hematology-Oncology, Chonnam National University Hwasun Hospital, Hwasun, Korea.

4Department of Hematology, Seoul National University Bundang Hospital, Seongnam, Korea.

5Department of Hematology, Gachon University Gil Hospital, Incheon, Korea.

6Department of Hematology-Oncology, Pusan National University Yangsan Hospital, Yangsan, Korea.

7Department of Nuclear Medicine, Pusan National University Hospital, Busan, Korea.

8Department of Pathology, Pusan National University Yangsan Hospital, Yangsan, Korea.

Correspondence to : Correspondence to Joo Seop Chung, M.D., Ph.D. Department of Hematology-Oncology, School of Medicine, Pusan National University, 179, Gudeok-ro, Seo-gu, Busan 602-739, Korea. Tel: +82-51-240-7225, Fax: +82-51-254-3127, Hemon@pusan.ac.kr

Received: February 10, 2015; Revised: March 11, 2015; Accepted: April 2, 2015

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

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Background

Few clinical studies have clarified the prognostic factors that affect clinical outcomes for patients with relapsed or refractory diffuse large B-cell lymphoma (DLBCL) after immunochemotherapy.

Methods

A total of 158 patients with relapsed or refractory DLBCL were enrolled. All patients underwent positron emission tomography/computed tomography (PET/CT) before and after salvage therapy. All enrolled patients previously received the ifosfamide, carboplatin, and etoposide regimen. Clinical outcomes were compared according to several factors (age ≥ 65 years, low age-adjusted International Prognostic Index [aa-IPI], maximum standardized uptake value [SUVmax] <6.0 on PET/CT, time to relapse ≥12 months, complete response after salvage therapy). A low aa-IPI, SUVmax <6.0, and time to relapse ≥ 12 months were independent prognostic factors for survival.

Results

In univariate analysis and multivariate analysis, SUVmax below 6.0 (P<0.001 for progression-free survival (PFS), P<0.001 for overall survival (OS)) and low aa-IPI (P<0.001 for PFS, P<0.001 for OS) were independent prognostic factors associated with favorable outcome.

Conclusion

The aa-IPI and initial SUVmax were powerful prognostic factors in patients with relapsed or refractory DLBCL.

Keywords Positron emission tomography, SUVmax, aa-IPI

Article

Original Article

Blood Res 2015; 50(2): 97-102

Published online June 25, 2015 https://doi.org/10.5045/br.2015.50.2.97

Copyright © The Korean Society of Hematology.

Maximum standardized uptake value on positron emission tomography/computed tomography predicts clinical outcome in patients with relapsed or refractory diffuse large B-cell lymphoma

Hee Ryeong Jang1, Moo Kon Song2, Joo Seop Chung2*, Deok Hwan Yang3, Jeong Ok Lee4, Junshik Hong5, Su Hee Cho6, Seong Jang Kim7, Dong Hoon Shin8, Young Joo Park1, Jin-Suk Kang1, Jeong Eun Lee1, Moon Won Lee1, and Ho-Jin Shin2

1Department of Internal Medicine, Pusan National University Hospital, Busan, Korea.

2Department of Hematology-Oncology, Pusan National University Hospital, Busan, Korea.

3Department of Hematology-Oncology, Chonnam National University Hwasun Hospital, Hwasun, Korea.

4Department of Hematology, Seoul National University Bundang Hospital, Seongnam, Korea.

5Department of Hematology, Gachon University Gil Hospital, Incheon, Korea.

6Department of Hematology-Oncology, Pusan National University Yangsan Hospital, Yangsan, Korea.

7Department of Nuclear Medicine, Pusan National University Hospital, Busan, Korea.

8Department of Pathology, Pusan National University Yangsan Hospital, Yangsan, Korea.

Correspondence to: Correspondence to Joo Seop Chung, M.D., Ph.D. Department of Hematology-Oncology, School of Medicine, Pusan National University, 179, Gudeok-ro, Seo-gu, Busan 602-739, Korea. Tel: +82-51-240-7225, Fax: +82-51-254-3127, Hemon@pusan.ac.kr

Received: February 10, 2015; Revised: March 11, 2015; Accepted: April 2, 2015

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Background

Few clinical studies have clarified the prognostic factors that affect clinical outcomes for patients with relapsed or refractory diffuse large B-cell lymphoma (DLBCL) after immunochemotherapy.

Methods

A total of 158 patients with relapsed or refractory DLBCL were enrolled. All patients underwent positron emission tomography/computed tomography (PET/CT) before and after salvage therapy. All enrolled patients previously received the ifosfamide, carboplatin, and etoposide regimen. Clinical outcomes were compared according to several factors (age ≥ 65 years, low age-adjusted International Prognostic Index [aa-IPI], maximum standardized uptake value [SUVmax] <6.0 on PET/CT, time to relapse ≥12 months, complete response after salvage therapy). A low aa-IPI, SUVmax <6.0, and time to relapse ≥ 12 months were independent prognostic factors for survival.

Results

In univariate analysis and multivariate analysis, SUVmax below 6.0 (P<0.001 for progression-free survival (PFS), P<0.001 for overall survival (OS)) and low aa-IPI (P<0.001 for PFS, P<0.001 for OS) were independent prognostic factors associated with favorable outcome.

Conclusion

The aa-IPI and initial SUVmax were powerful prognostic factors in patients with relapsed or refractory DLBCL.

Keywords: Positron emission tomography, SUVmax, aa-IPI

Fig 1.

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Figure 1.

Comparison of clinical outcomes according to the age-adjusted International Prognostic Index (aa-IPI).

Blood Research 2015; 50: 97-102https://doi.org/10.5045/br.2015.50.2.97

Fig 2.

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Figure 2.

Comparison of clinical outcomes according to a maximum standardized uptake value (SUVmax) cut-off of 6.0.

Blood Research 2015; 50: 97-102https://doi.org/10.5045/br.2015.50.2.97
Baseline characteristics of the patients.

Abbreviations: ECOG, Eastern Cöoperative Oncology Group; PS, performance Status; LDH, lactate dehydrogenase; EN, extranodal; IPI, international prognostic index; SUVmax, maximum standardized uptake value; PET/CT, position emission tomography/computed tomography; CR, complete response..
Univariate analysis of the prognostic factors predicting the clinical outcomes.

Abbreviations: HR, hazard ratio; CI, confidence interval; aa-IPI, age adjusted-international prognostic index; SUVmax, maximum standardized uptake value; CR, complete response..
Multivariate analysis of the prognostic factors predicting the clinical outcomes.

Abbreviations: HR, hazard ratio; CI, confidence interval; aa-IPI, age adjusted-international prognostic index; SUVmax, maximum standardized uptake value; CR, complete response..
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