Lenfomalarda Kemik İliği Transplantasyon Öncesi ve 100. Gün Değerlendirmesinde PET-BT Tetkikinin Prognostik Önemi
Özet
In patients with lymphoma, pretransplantation 18-fluorodeoxyglucose (FDG)-positron-emission tomography (PET) was important for the evaluation of response and outcome. However, little is known about the correlation of FDG-PET with post-transplantation PET. The current study was designed to ascertain predictive value of FDG-PET imaging before and after stem cell transplantation (SCT) in lymphoma patients. We conducted retrospective and prospective analysis of 32 lymphoma patients (11 Hodgkin's disease and 21 non-Hodgkin's lymphoma) who had an FDG-PET scan before SCT (after salvage chemotherapy) and after 100 days (D-100) post-transplantation. The correlation was explored between the presence of abnormal 18-FDG uptake (PET positive) or its absence (PET negative) and patient outcomes. Before SCT, 15 (47%) patients were had negative PET images; and, after SCT, 21 patients (66%) had negative PET images. The PPV, NPV and accuracy for pre- SCT PET were 65%, 87% and 75%, respectively, and 100%, 90% and 94% for post-SCT, suggesting importance of D-100 pre and post SCT in the prediction of outcome in lymphoma patients who undergo SCT. The Overall survival (OS) was 14.6 and 13 months respectively in patients who had a negative pre-SCT PET. In patients who had a negatif PET after SCT, OS was 14.8 months and 11.7 months in ones with positive PET. OS in the lymphoma patients was statistically different between the post-SCT PET negative group and the PET positive group (p<0.05). Thus, the overall study demonstrated that a negative FDG PET scan 100 days after SCT does predict a significantly better OS in lymphoma patients.
