Abstract:
BACKGROUND: Besides International Prognostic Index (IPI) score, baseline prognostic factors of post-transplant lymphoproliferative disorders (PTLD) are poorly identified due to the rarity of the disease. New indexes derived from healthy organ uptake in baseline 18F-FDG PET/CT have been studied in immunocompetent lymphoma patients. The aim of this study is to evaluate the performances of the cerebellum-to-liver uptake ratio (denoted as CLIP) as a prognostic factor for PFS and OS. This retrospective multicenter study is based on patients with PTLD included in the K-VIROGREF cohort. The previously published threshold of 3.24 was used for CLIP in these analyses.
RESULTS: A total of 97 patients was included with a majority of monomorphic diffuse large B-cell lymphoma subtype (78.3%). Both IPI score (≥ 3) and CLIP (< 3.24) were significant risk factors of PFS with corresponding hazard ratios of 2.0 (1.0-4.0) and 2.4 (1.3-4.5) respectively. For OS, CLIP was not significant and resulted in a hazard ratio of 2.6 (p = 0.059). Neither IPI score or Total Metabolic Tumor Volume reached significance for OS.
CONCLUSIONS: CLIP is a promising predictor of PFS and perhaps OS in PTLD. Further prospective studies are needed to confirm these results.
摘要:
背景:除了国际预后指数(IPI)评分,移植后淋巴组织增殖性疾病(PTLD)的基线预后因素,由于该病的罕见性,尚不明确.已在免疫活性淋巴瘤患者中研究了基线18F-FDGPET/CT中来自健康器官摄取的新指标。这项研究的目的是评估小脑与肝脏摄取比(表示为CLIP)作为PFS和OS的预后因素的表现。这项回顾性多中心研究基于K-VIROGREF队列中的PTLD患者。先前公布的阈值3.24用于这些分析中的CLIP。
结果:共有97例患者被纳入大多数为单形弥漫性大B细胞淋巴瘤亚型(78.3%)。IPI评分(≥3分)和CLIP评分(<3.24分)均为PFS的显著危险因素,其风险比分别为2.0(1.0-4.0)和2.4(1.3-4.5)。对于操作系统,CLIP不显著,并且导致2.6的危险比(p=0.059)。IPI评分或总代谢性肿瘤体积均未达到OS的显著性。
结论:CLIP是PTLD中PFS和OS的有希望的预测指标。需要进一步的前瞻性研究来证实这些结果。