Baseline and interim functional imaging with PET effectively risk stratifies patients with peripheral T-cell lymphoma Journal Article

Authors: Mehta-Shah, N.; Ito, K.; Bantilan, K.; Moskowitz, A. J.; Sauter, C.; Horwitz, S. M.; Schöder, H.
Article Title: Baseline and interim functional imaging with PET effectively risk stratifies patients with peripheral T-cell lymphoma
Abstract: The prognosis of peripheral T-cell lymphoma (PTCL) is heterogenous. Baseline or interim imaging characteristics may inform risk-adapted treatment paradigms. We identified 112 patients with PTCL who were consecutively treated with cyclophosphamide, doxorubicin, vincristine, prednisone (CHOP)/CHOP-like regimens with the intent to consolidate with an autologous transplant. Baseline (n = 93) and interim (after 4 cycles, n = 99) positron emission tomography (PET) images were reevaluated, and we calculated baseline total metabolic tumor volume (TMTV). Interim PET (iPET) responses were graded visually by 5-point score (i5PS) and by percentage change of standardized uptake value. By univariate analysis, predictors of event-free survival (EFS) included Prognostic Index for Peripheral TCL (PIT) higher than 1 (hazard ratio [HR], 1.83; P = .021), International Prognostic Index (IPI) higher than 3 (HR, 2.01; P = .021), high TMTV (>125 cm3; HR, 3.92; P = .003), and positive iPET (HR, 3.57; P < .001). By multivariate analysis, high baseline TMTV predicted worse overall survival (OS; HR, 6.025; P = .022) and EFS (HR, 3.861; P = .005). Patients with i5PS of 1 to 3 had a longer median OS and EFS (104 months, 64 months) than those with i5PS of 4 to 5 (19 months, 11 months; P < .001). Four-year OS and EFS for patients with i5PS of 1 to 3 and PIT of 1 or less were 85% and 62%, respectively. However, 4-year OS and EFS for those with i5PS of 4 to 5 and PIT higher than 1 were both 0% (P < .001). In multivariate analysis, after controlling for IPI and PIT, i5PS was independently prognostic for EFS (HR, 3.400 95% confidence interval, 1.750-6.750; P < .001) and OS (HR, 10.243; 95% confidence interval, 4.052-25.891; P < .001). In conjunction with clinical parameters, iPET helps risk stratify patients with PTCL and could inform risk-adapted treatment strategies. Prospective studies are needed to confirm these findings. © 2019 by The American Society of Hematology.
Journal Title: Blood Advances
Volume: 3
Issue: 2
ISSN: 2473-9529
Publisher: American Society of Hematology  
Date Published: 2019-01-22
Start Page: 187
End Page: 197
Language: English
DOI: 10.1182/bloodadvances.2018024075
PUBMED: 30670535
PROVIDER: scopus
PMCID: PMC6341183
Notes: Article -- Export Date: 1 March 2019 -- Source: Scopus
Citation Impact
MSK Authors
  1. Steven M Horwitz
    418 Horwitz
  2. Heiko Schoder
    333 Schoder
  3. Craig Steven Sauter
    204 Sauter
  4. Alison Moskowitz
    184 Moskowitz
  5. Neha Mehta Shah
    19 Shah
  6. Kimiteru Ito
    17 Ito