Prognostic significance of interim PET/CT response for the treatment of advanced-stage marginal zone lymphoma in the post-rituximab era

Ga Young Song, Sang Eun Yoon, Seok Jin Kim, Jin Seok Kim, Youngil Koh, Joon Ho Moon, Sung Yong Oh, Ho Sup Lee, Ho Jin Shin, Young Rok Do, Won Sik Lee, Dae sik Kim, Yong Park, Ho Young Yhim, Deok Hwan Yang

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Abstract

There are still controversies about the use of interim positron emission tomography/computed tomography (PET/CT) in indolent non-Hodgkin lymphoma due to the variable fluorodeoxyglucose (FDG) avidity. Therefore, this study aimed to evaluate the roles of interim PET/CT in marginal zone lymphoma (MZL), a representative indolent lymphoma. We analyzed the data of 146 MZL patients. All were treated with rituximab-containing immunochemotherapy. Interim PET/CT scan was performed after 2–3 cycles of therapy, and the response was assessed using the Deauville 5-point scales (5-PS) and a semi-quantitative assessment using the SUVmax reduction rate (ΔSUVmax). Progression-free survival (PFS) was well stratified according to a visual assessment of interim PET/CT using 5-PS (p < 0.001). Particularly, there was a significant difference in PFS between patients with interim score 1–2 and those with score 3. However, ΔSUVmax did not predict the survival outcome using 59.8% of the optimal cutoff value. In the multivariate analysis, failure to achievement of grade 1–2 in interim PET/CT was significantly associated with inferior PFS (HR, 2.154; 95% CI 1.071–4.332; p = 0.031). The interim PET/CT response based on the 5-PS is useful for predicting PFS of patients with MZL in the post-rituximab era.

Original languageEnglish
Article number11649
JournalScientific reports
Volume10
Issue number1
DOIs
Publication statusPublished - 2020 Dec 1

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    Song, G. Y., Yoon, S. E., Kim, S. J., Kim, J. S., Koh, Y., Moon, J. H., Oh, S. Y., Lee, H. S., Shin, H. J., Do, Y. R., Lee, W. S., Kim, D. S., Park, Y., Yhim, H. Y., & Yang, D. H. (2020). Prognostic significance of interim PET/CT response for the treatment of advanced-stage marginal zone lymphoma in the post-rituximab era. Scientific reports, 10(1), [11649]. https://doi.org/10.1038/s41598-020-68310-w