Prognostic Significance of PET/CT in Patients with Chronic Lymphocytic Leukemia (CLL) Treated with Frontline Chemoimmunotherapy.
Marika PorrazzoEmanuele NicolaiMara RiminucciCandida VitaleMarta CosciaLorenzo De PaoliAngela RagoGiulia BuscicchioGiacomo MaestriniSilvio LigiaAlessio Di PrimaAlessandro CorsiRoberto CaronnaGianluca GaidanoFrancesca Romana MauroPublished in: Cancers (2020)
The role of positron emission tomography/computed tomography (PET/CT) in identifying Richter Syndrome (RS) is well established, while its impact on the survival of patients with chronic lymphocytic leukemia (CLL) has been less explored. The clinical characteristics and PET/CT data of 40 patients with a biopsy-proven CLL who required frontline chemoimmunotherapy, FCR (fludarabine, cyclophosphamide, rituximab) in 20 patients, BR (bendamustine, rituximab) in 20, were retrospectively analyzed. Standardized uptake volume (SUVmax) values ≥ 5 were observed more frequently in patients with deletion 11q (p = 0.006) and biopsies characterized by a rate of Ki67 positive cells ≥ 30% (p = 0.02). In the multivariate analysis, the presence of large and confluent PCs emerged as the only factor with a negative impact on progression-free survival (PFS), and overall survival (OS). Deletion 11q also revealed a significant and independent effect on PFS. SUVmax values ≥ 5 showed no statistical impact on PFS while in multivariate analysis, they revealed a significant adverse impact on OS (median survival probability not reached vs. 56 months; p = 0.002). Moreover, patients with higher SUVmax values more frequently developed Richter Syndrome (p = 0.015). Our results show that higher SUVmax values identify CLL patients with a pronounced rate of proliferating cells in the lymph-node compartment, inferior survival, and an increased risk of developing RS.
Keyphrases
- chronic lymphocytic leukemia
- pet ct
- positron emission tomography
- free survival
- computed tomography
- lymph node
- induced apoptosis
- end stage renal disease
- newly diagnosed
- cell cycle arrest
- data analysis
- pet imaging
- magnetic resonance imaging
- peritoneal dialysis
- chronic kidney disease
- single cell
- low dose
- emergency department
- oxidative stress
- squamous cell carcinoma
- endoplasmic reticulum stress