Journal Article

Diagnostic and prognostic role of PET/CT in patients with chronic lymphocytic leukemia and progressive disease

Guarini, A, Chauvie, S, Gentile, M, Bellò, M, Gallamini, A, Nicolai, E, Cimino, G, Sacchetti, G M, Campanelli, M, Laurenti, L, Autore, F, Morabito, F, Biggi, A, Rossi, D, Riminucci, M, Foà, R, Rago, A, Trastulli, F, Gaidano, G, Coscia, M, Paoloni, F, Mauro, F R

2015

Overview

In order to evaluate the predictive value of positron emission tomography–computed tomography (PET/CT) in discriminating the presence of a Richter’s syndrome (RS) or a second malignancy (SM), as well as to evaluate its prognostic value in patients with chronic lymphocytic leukemia (CLL), we retrospectively analyzed the data of 90 patients who, in the suspicion of a RS or a SM, underwent PET/CT followed by the biopsy of the involved tissue. The median maximum Standardized Uptake Value (SUV max ) in the presence of a CLL/small lymphocytic lymphoma, a diffuse large B-cell lymphoma (DLBCL), a Hodgkin lymphoma (HL), a SM were 3.5, 14.6, 7.0 and 6.3, respectively ( P ⩽0.0001). A SUV max cutoff value ⩾5 showed a sensitivity, specificity, positive and negative predictive values of 88.2, 71.2, 51.3 and 94%, respectively, for the presence of a more aggressive disease (DLBCL, HL and SM). A SUV max ⩾5 identified also a subset of treatment naive patients with an inferior progression-free survival ( P =0.011) and overall survival ( P =0.067). These findings suggest that PET/CT may helpfully integrate the biologically-based prognostic stratification of CLL. Prospective clinical trials including larger cohorts of patients are needed to conclusively define the role and prognostic impact of PET/CT in the routine management of CLL patients.

• Publisher: Nature Publishing Group UK,Nature Publishing Group
• Subject: 692/308 / 692/699/1541/1990/283/1895 / 692/700/1421/1846/2092 / 692/700/1421/1846/2771 / 692/700/1750 / Adult / Aged / Aged, 80 and over / B-cell lymphoma / Biopsy / Cancer Research / Care and treatment / CAT scans / Chronic lymphocytic leukemia / Clinical trials / Combined Modality Therapy / Computed tomography / Critical Care Medicine / Diagnosis / Diagnostic systems / Emission analysis / Female / Follow-Up Studies / Hematology / Hodgkin Disease - diagnosis / Hodgkin Disease - mortality / Hodgkin Disease - therapy / Hodgkin's lymphoma / Humans / Intensive / Internal Medicine / Leukemia / Leukemia, Lymphocytic, Chronic, B-Cell - diagnosis / Leukemia, Lymphocytic, Chronic, B-Cell - mortality / Leukemia, Lymphocytic, Chronic, B-Cell - therapy / Lymphatic leukemia / Lymphocytes B / Lymphoma / Lymphoma, Large B-Cell, Diffuse - diagnosis / Lymphoma, Large B-Cell, Diffuse - mortality / Lymphoma, Large B-Cell, Diffuse - therapy / Male / Malignancy / Medical diagnosis / Medical prognosis / Medicine / Medicine & Public Health / Methods / Middle Aged / Neoplasm Staging / Neoplasms, Second Primary - diagnosis / Neoplasms, Second Primary - mortality / Neoplasms, Second Primary - therapy / Oncology / original-article / Patients / Positron emission / Positron emission tomography / Positron-Emission Tomography - methods / Precision medicine / Prognosis / Retrospective Studies / Survival / Survival Rate / Tomography / Tomography, X-Ray Computed - methods