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European Journal of Nuclear Medicine and Molecular Imaging

Published in:

01-09-2018 | Original Article

Prognostic value of [¹⁸F]FDG-PET/CT in multiple myeloma patients before and after allogeneic hematopoietic cell transplantation

Authors: Antje Stolzenburg, Katharina Lückerath, Samuel Samnick, Martin Speer, Katharina Kneer, Jan-Stefan Schmid, Götz Ulrich Grigoleit, Susanne Hofmann, Ambros J. Beer, Donald Bunjes, Stefan Knop, Andreas K. Buck, Hermann Einsele, Constantin Lapa

Published in: European Journal of Nuclear Medicine and Molecular Imaging | Issue 10/2018

Abstract

Purpose

Despite improved treatment options, multiple myeloma (MM) remains an incurable disease. The aim of this study was to investigate the prognostic value of positron emission tomography/computed tomography (PET/CT) using ¹⁸F-2’-deoxy-2’-fluorodeoxyglucose ([¹⁸F]FDG) in MM patients shortly before and ~100 days after allogeneic hematopoietic cell transplantation (allo-HCT).

Methods

In this retrospective analysis, we evaluated [¹⁸F]FDG-PET/CT-scans of 45 heavily pre-treated MM patients before and 27 patients after scheduled allo-HCT. All scans were qualitatively and semi-quantitatively assessed for the presence of active disease. Serological response was recorded according to International Myeloma Working Group (IMWG) criteria. Progression-free (PFS) and overall survival (OS) were correlated with different PET/CT-derived parameters, such as presence, number and maximum standardized uptake value (SUV_max) of focal myeloma lesions. The impact of extramedullary disease on patient outcome was also assessed.

Results

PET/CT negativity -prior to or following allo-HCT- was a favorable prognostic factor for progression-free and overall survival (both, PFS and OS: pre-HSCT p < 0.001, post-HCT p < 0.005). High FDG-uptake (SUV_max > 6.5) revealed a significantly shortened survival compared to patients with a lower SUV_max (<6.5) (OS, 5.0 ± 1.1 m vs. not reached - longest 122.0 m; p < 0.001). Moreover, our data prove that a higher number (>3) of focal lesions (pre-HCT: both PFS and OS: p < 0.001; post-HCT PFS: p < 0.001, OS: p = 0.139) as well as the presence of extramedullary disease serve as adverse prognostic factors prior to and after allo-HCT. At response assessment after allo-HCT, [¹⁸F]FDG-PET/CT had a complementary value in prognostication in addition to IMWG criteria alone.

Conclusion

[¹⁸F]FDG-PET/CT before and shortly after allogeneic HCT is a powerful predictor for progression-free and overall survival in MM patients.

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Title: Prognostic value of [18F]FDG-PET/CT in multiple myeloma patients before and after allogeneic hematopoietic cell transplantation
Authors: Antje Stolzenburg
Katharina Lückerath
Samuel Samnick
Martin Speer
Katharina Kneer
Jan-Stefan Schmid
Götz Ulrich Grigoleit
Susanne Hofmann
Ambros J. Beer
Donald Bunjes
Stefan Knop
Andreas K. Buck
Hermann Einsele
Constantin Lapa
Publication date: 01-09-2018
Publisher: Springer Berlin Heidelberg
Published in: European Journal of Nuclear Medicine and Molecular Imaging / Issue 10/2018
Print ISSN: 1619-7070
Electronic ISSN: 1619-7089
DOI: https://doi.org/10.1007/s00259-018-3997-0

At a glance: The STEP trials

Springer Medicine

Prognostic value of [¹⁸F]FDG-PET/CT in multiple myeloma patients before and after allogeneic hematopoietic cell transplantation

Abstract

Purpose

Methods

Results

Conclusion

At a glance: The STEP trials

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusion

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