Nucl Med Mol Imaging.  2020 Feb;54(1):28-34. 10.1007/s13139-019-00630-w.

Prognostic Value of Bone Marrow F-18 FDG Uptake in Patients with Advanced-Stage Diffuse Large B-Cell Lymphoma

• Wang J
• Kim D
• Kang WJ
• Cho H

• KMID: 2507675
• DOI: http://doi.org/10.1007/s13139-019-00630-w

Abstract

Purpose
We assessed prognostic implication of bone marrow uptake on baseline F-18 fluorodeoxyglucose positron emission tomography/computed tomography (FDG PET/CT) in patients with advanced-stage diffuse large B-cell lymphoma (DLBCL).
Methods
We retrospectively reviewed 140 patients with stage III and IV DLBCL, who underwent baseline F-18 FDG PET/CT at diagnosis. Bone marrow uptake on F-18 FDG PET/CT (BM FDG) was compared with findings on bone marrow biopsy (BMB), and patients were grouped based on these results: BMB-positive and BM FDG-positive (group 1), BMB-positive and BM FDG-negative (group 2), BMB-negative and BM FDG-positive (group 3), and BMB-negative and BM FDG-negative (group 4). The prognostic value of clinicopathologic factors and BM FDG for predicting progression-free survival (PFS) and overall survival (OS) was assessed using a Cox proportional hazards model. Differences in PFS and OS were examined by the Kaplan-Meier method.
Results
BMB was the only significant indicator in predicting PFS, and age, IPI score higher than 3, and BM FDG significantly predicted OS. Group 1 showed inferior PFS than group 2 (median PFS, 7.4 vs. 13.9 months; p = 0.04). In contrast, there was no significant difference either in PFS or OS between group 2 and group 3.
Conclusion
We showed that BM FDG-positive predicted a poorer survival in patients with advanced stage DBLCL. We also found that BMB-negative and BM FDG-positive patients had similar PFS or OS to BMB-positive and BM FDG-negative patients. Further study in a larger population is needed to clarify clinical significance of BM FDG in these patients.

Keyword

Diffuse large B-cell lymphoma; Fluorodeoxyglucose; Bone marrow involvement; Prognosis