MDCT seems to be preferable to conventional radiography in evaluating bone destruction in multiple myeloma. In combination with MR imaging, detailed information for staging these tumors is obtained. For the initial staging in patients with multiple myeloma, MDCT in combination with MR imaging seems to be the method of choice.

Summary:We investigated the predictive value of sequential FDG PET before and after high-dose chemotherapy (HDT) and autologous stem cell transplantation (ASCT) in 24 patients suffering from non-Hodgkin's lymphoma (NHL). FDG PET was performed at baseline, after three cycles of induction therapy, before and after HDT with ASCT. Response assessment from sequential PET scans using standardized uptake values (SUV) was available in 22 patients at the time of transplantation. Partial metabolic response (PMR) was defined as a Ͻ25% decrease of SUV between successive PET scans. Six of seven patients who did not achieve a PMR after complete induction therapy developed lymphoma progression, while 10 of 15 patients with complete metabolic response (CMR) or PMR remained in continuous remission. Four of seven patients with less than PMR after induction therapy died vs two of 15 patients with CMR/PMR. Median progression-free and overall survival of patients with less than PMR after HDT and ASCT was 9 and 29 months, respectively. In contrast, neither conventional re-staging nor the International Prognostic Index were predictive. These data suggest that sequential quantitative PET imaging does enlarge the concept of chemosensitivity used to select patients with high-risk NHL for HDT and ASCT or to route them to alternative treatments. High-dose chemotherapy (HDT) with autologous stem cell transplantation (ASCT) has been shown to be the best available treatment in patients who have relapsed from nonHodgkin's lymphoma (NHL) after conventional chemotherapy, but who remained chemotherapy-sensitive.1 This has prompted the use of HDT with ASCT as a front-line therapy in patients with high-intermediate or high risk disease according to the International Prognostic Index.2 However, clinical results have been discrepant and additional prognostic factors are needed to predict final outcome of the patients at the time of transplantation.Positron emission tomography (PET) using the glucose analogue fluorine-18-fluorodeoxglucose (FDG) has been demonstrated to improve primary staging of lymphoma and to be more precise than conventional radiological imaging for re-staging after chemotherapy.3-7 Several groups including our own have reported the high predictive value of persisting abnormal FDG uptake for residual or recurrent disease in this context. 7-9Thus FDG-PET does have a potential role in the identification of patients requiring further intensified chemotherapy. Moreover, FDG-PET can be used as a functional and quantitative measure of tumor response to induction chemotherapy 10 and may be able to differentiate between responders and non-responders at an earlier time-point than conventional CT or MRI imaging. Preliminary results in a small patient population studied before onset of treatment and again after one and two chemotherapy cycles support this hypothesis. 11We prospectively enrolled consecutive patients with NHL who were scheduled for HDT including ASCT. Progression-free and overall survival were chosen as end points of the study....

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We compared test methods based on specific mechanisms of some interest as a novel approach for the determination of daunorubicin (DNR) resistance to more global procedures.chemosensitivity. [4][5][6] Assessment of P-glycoprotein (P-gp) expression and function Expression of P-glycoprotein (P-gp), accumulation of dau- then performed with a set of leukemic blood samples from 18Low proficiency of MNC to undergo apoptosis and low proliferative activity rather than P-gp-mediated MDR correlated with different patients. and human HL-60 promyelocytic leukemia cells were used.

Approximately 20% of patients with systemic mastocytosis (SM) have an associated haematological, clonal, non-mast cell lineage disease, and most exhibit an associated myelogenous neoplasm. This report describes a 48 year old man with acute myeloid leukaemia (AML) and a type t(8;21) cytogenetic abnormality. Associated bone marrow mastocytosis (a defined subtype of SM) was only detected after successful polychemotherapy in the state of bone marrow aplasia, and persisted after complete remission of AML. The diagnosis of mastocytosis was based on the demonstration of a multifocal dense mastocytic infiltrate. The atypical mast cells showed prominent spindling and an aberrant immunophenotype, with coexpression of tryptase, chymase, KIT, and CD25—which is expressed only on neoplastic (not normal) mast cells. In addition, the transforming somatic mutation D816V of the c-kit gene was detected. Re-examination of the pretherapeutic (initial) bone marrow revealed a slight diffuse increase in partially spindle shaped mast cells also exhibiting an abnormal immunophenotype, with CD25 expression, although compact mastocytic infiltrates were not detected. Because the D816V mutation was detected in the initial bone marrow specimen, strict application of three minor diagnostic criteria (spindling, CD25, D816V) enabled a diagnosis of SM-AML to be confirmed retrospectively in the initial bone marrow tissue.