Utility of the PET–CT in the evaluation of early response to treatment in the diffuse large B-cell lymphoma. Preliminary results

Romera, M. Cortés; Cenzano, Cristina Gámez; Aróztegui, A.P. Caresia; Martín-Comín, J.; González‐Barca, Eva; Brulles, Y. Ricart; Abufón, A. Palacios; Barba, J.; Rodríguez-Bel, Laura; Seoane, S. Rossi; Sevilla, Alberto Fernández de

doi:10.1016/j.remnie.2012.05.004

Cited by 4 publications

(1 citation statement)

References 27 publications

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“…Skin biopsy from the plaques in such patients showed dense infiltrates of large lymphocytes with irregularly shaped nuclei and prominent nucleoli in the dermis and subcutaneous tissue 3. FDG-PET/CT after the first cycles of chemotherapy is useful to monitor treatment due to its high negative predictive value (87.5%), using it to modify treatment early in the non-responders 4. This case highlights a typical presentation of diffuse B cell lymphoma and PET scan as a modality of investigation.…”

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confidence: 92%

Diffuse large B cell lymphoma: cutaneous manifestation

Sajjan

Haroon²,

Saad³

et al. 2011

Case Reports

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DESCRIPTIONA 47-year-old gentleman was diagnosed with diffuse B cell lymphoma. His initial presentation was skin lesions. He was then referred for patch test with a diagnosis of periorbital eczema. Later, patient developed varicose veins and skin lesions in the right leg which was operated upon with poor healing and subsequent skin biopsy of the lesions demonstrated diffuse large B cell lymphoma (DLBCL). The bone marrow biopsy proved marrow involvement. He had no B symptoms. His past medical history includes brain abscess aged 9 months which was operated upon and left him with some weakness on the left side. He is married with two children. No signifi cant illnesses in the family. Patient had six to eight cycles of R-CHOP chemotherapy, however he had progression of lymphoma within 2 months of R-CHOP chemotherapy. He then represented with extensive skin lesions. He was referred for positron emission tomography (PET) scan which was performed using radioisotope 18FDG which confi rmed extensive involvement of skin. The pictures show the skin lesions ( fi gure 1 ) at the time patient was referred for PET and a corresponding picture of PET image ( fi gure 2 ). The patient had further chemotherapy with oral CCEP (Cytoxan, CCNU, Etoposide and Prednisone) which resulted in complete remission. Currently, he is awaiting peripheral blood stem cell autograft. DLBCL is the most common histological subtype of non-Hodgkin's lymphoma (NHL) accounting for approximately 30-58% of adult NHL cases. 1 It is aggressive form of NHL and sixth most common cancer in the UK. 2 Most frequently, diffuse large cell lymphomas appear in lymphoreticuloendothelial tissues, which include the lymph nodes, spleen, liver and bone marrow. However, any extra nodal site may be primarily or secondarily involved. Skin biopsy from the plaques in such patients showed dense infi ltrates of large lymphocytes with irregularly shaped nuclei and prominent nucleoli in the dermis and subcutaneous tissue. 3 FDG-PET/CT after the fi rst cycles of chemotherapy is useful to monitor treatment due to its high negative predictive value (87.5%),

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Section: Descriptionmentioning

confidence: 92%

Diffuse large B cell lymphoma: cutaneous manifestation

Sajjan

Haroon²,

Saad³

et al. 2011

Case Reports

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Quantitative and qualitative evaluation of the interim PET/CT in lymphoma treatment in the prediction of complete metabolic response

Woll

Vicente

Rubio

et al. 2013

Revista Española de Medicina Nuclear e Imagen Molecular (Englis

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Predictive Significance of a New Prognostic Score for Patients With Diffuse Large B-Cell Lymphoma in the Interim-Positron Emission Tomography Findings

Kong

et al. 2016

Medicine

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We hypothesized that the objective treatment response of patients with diffuse large B-cell lymphoma (DLBCL) was affected by many factors such as pathophysiological, biological, and pharmaceutical mechanisms. This retrospective study aimed to evaluate the predictive significance of clinical prognostic factors and interim fluorine-18-fluorodeoxyglucose (18F-FDG) positron emission tomography/computed tomography (PET/CT), and to find a new prognostic predictor significantly associated with DLBCL patients’ outcome. A total of 105 adult patients with DLBCL were reviewed. Each patient underwent an interim 18F-FDG PET/CT scan after the second chemotherapy cycle. The visual method based on the Deauville 5-point scale was used to evaluate the interim-PET/CT scans. The relationships among the prognostic factors, the 3-year progression-free survival (PFS) rate and overall survival (OS) rate were analyzed with Kaplan–Meier plots. The predictive value of the newly constructed prognostic score was analyzed with multivariate analysis (Cox proportional hazard regression model). The visual analysis showed statistically significant differences in both PFS and OS between the patients with a negative interim-PET/CT and those with a positive interim-PET/CT. Advanced age, advanced stage, and DLBCL subtype were also significantly associated with outcome. A new prognostic score that composed of the above 4 factors was obtained. New prognostic score stratified patients into 4 risk groups with 3-year PFS of 98.5%, 73.9%, 11.1%, and 0%, and 3-year OS of 100%, 91.3%, 55.6%, and 0% (P < 0.001 for PFS and OS). Multivariate analysis showed that the new prognostic score had the greatest ability to predict relapse (P < 0.001) and death (P < 0.001). In DLBCL patients, interim 18F-FDG PET/CT can provide significant independent prognostic information. Our work illustrates that the new prognostic score has the strongest potential for accurately prognostication, for stratification in clinical trials, and for design of novel strategies for DLBCL patients in the high-risk group.

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Utility of the PET–CT in the evaluation of early response to treatment in the diffuse large B-cell lymphoma. Preliminary results

Cited by 4 publications

References 27 publications

Diffuse large B cell lymphoma: cutaneous manifestation

Diffuse large B cell lymphoma: cutaneous manifestation

Quantitative and qualitative evaluation of the interim PET/CT in lymphoma treatment in the prediction of complete metabolic response

Predictive Significance of a New Prognostic Score for Patients With Diffuse Large B-Cell Lymphoma in the Interim-Positron Emission Tomography Findings

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