Risk stratification of diffuse large B-cell lymphoma with interim PET-CT based on different cutoff Deauville scores

Leuk Lymphoma. 2018 Feb;59(2):340-347. doi: 10.1080/10428194.2017.1339877. Epub 2017 Jun 20.

Abstract

We evaluated the usefulness of interim 18F-FDG PET/CT for risk stratification using different cutoff values of the Deauville 5-point scale (5-DS) in DLBCL patients treated with rituximab plus cyclophosphamide, doxorubicin, vincristine, and prednisone (R-CHOP). One hundred and fifty patients underwent interim (I-) and end of treatment (EOT-) PET/CT scans. Applying the conventional 5-DS cutoff value of scores 4 to 5 at interim, there was no significant difference in progression free survival (PFS) between I-PET negative and I-PET positive patients. In comparison, PFS was inferior in patients with a score of 5 on I-PET scan compared with those with a score in between 1 to 4 (28.6% vs. 78.7%, p < .0001), and positive predictive value (71.4%) was improved compared to that obtained using cutoff value of scores 4 to 5 (34.9%). Our study shows that a cutoff score of 5 at interim has an alternative clinical implication for identifying patients at a significant risk.

Keywords: Deauville 5-point scale; diffuse large B-cell lymphoma; interim positron-emission tomography; prognosis.

MeSH terms

  • Adult
  • Aged
  • Antibodies, Monoclonal, Murine-Derived / therapeutic use
  • Antineoplastic Combined Chemotherapy Protocols / therapeutic use
  • Biomarkers
  • Cyclophosphamide / therapeutic use
  • Doxorubicin / therapeutic use
  • Female
  • Fluorodeoxyglucose F18
  • Humans
  • Image Interpretation, Computer-Assisted
  • Image Processing, Computer-Assisted
  • Kaplan-Meier Estimate
  • Lymphoma, Large B-Cell, Diffuse / diagnosis*
  • Lymphoma, Large B-Cell, Diffuse / drug therapy
  • Male
  • Middle Aged
  • Neoplasm Staging
  • Positron Emission Tomography Computed Tomography*
  • Prednisone / therapeutic use
  • Prognosis
  • Reference Values
  • Rituximab
  • Sensitivity and Specificity
  • Treatment Outcome
  • Vincristine / therapeutic use

Substances

  • Antibodies, Monoclonal, Murine-Derived
  • Biomarkers
  • R-CHOP protocol
  • Fluorodeoxyglucose F18
  • Rituximab
  • Vincristine
  • Doxorubicin
  • Cyclophosphamide
  • Prednisone