Prognostic value of baseline total metabolic tumor volume (TMTV0) measured on FDG-PET/CT in patients with peripheral T-cell lymphoma (PTCL).

BACKGROUND Most peripheral T-cell lymphoma (PTCL) patients have a poor outcome and the identification of prognostic factors at diagnosis is needed. PATIENTS AND METHODS The prognostic impact of total metabolic tumor volume (TMTV0), measured on baseline [(18)F]2-fluoro-2-deoxy-d-glucose positron emission tomography/computed tomography, was evaluated in a retrospective study including 108 PTCL patients (27 PTCL not otherwise specified, 43 angioimmunoblastic T-cell lymphomas and 38 anaplastic large-cell lymphomas). All received anthracycline-based chemotherapy. TMTV0 was computed with the 41% maximum standardized uptake value threshold method and an optimal cut-off point for binary outcomes was determined and compared with others prognostic factors. RESULTS With a median follow-up of 23 months, 2-year progression-free survival (PFS) was 49% and 2-year overall survival (OS) was 67%. High TMTV0 was significantly associated with a worse prognosis. At 2 years, PFS was 26% in patients with a high TMTV0 (>230 cm(3), n = 53) versus 71% for those with a low TMTV0, [P < 0.0001, hazard ratio (HR) = 4], whereas OS was 50% versus 80%, respectively, (P = 0.0005, HR = 3.1). In multivariate analysis, TMTV0 was the only significant independent parameter for both PFS and OS. TMTV0, combined with PIT, discriminated even better than TMTV0 alone, patients with an adverse outcome (TMTV0 >230 cm(3) and PIT >1, n = 33,) from those with good prognosis (TMTV0 ≤230 cm(3) and PIT ≤1, n = 40): 19% versus 73% 2-year PFS (P < 0.0001) and 43% versus 81% 2-year OS, respectively (P = 0.0002). Thirty-one patients (other TMTV0-PIT combinations) had an intermediate outcome, 50% 2-year PFS and 68% 2-year OS. CONCLUSION TMTV0 appears as an independent predictor of PTCL outcome. Combined with PIT, it could identify different risk categories at diagnosis and warrants further validation as a prognostic marker.

[1]  M. Bøgsted,et al.  Utility of interim and end‐of‐treatment PET/CT in peripheral T‐cell lymphomas: A review of 124 patients , 2015, American journal of hematology.

[2]  T. Molina,et al.  Angioimmunoblastic T-cell lymphoma is the most common T-cell lymphoma in two distinct French information data sets , 2015, Haematologica.

[3]  F. Cavalli,et al.  Utility of baseline 18FDG-PET/CT functional parameters in defining prognosis of primary mediastinal (thymic) large B-cell lymphoma. , 2015, Blood.

[4]  S. Hyun,et al.  Risk stratification on the basis of Deauville score on PET-CT and the presence of Epstein-Barr virus DNA after completion of primary treatment for extranodal natural killer/T-cell lymphoma, nasal type: a multicentre, retrospective analysis. , 2015, The Lancet. Haematology.

[5]  B. Coiffier,et al.  Utility of 18fluoro-deoxyglucose positron emission tomography for prognosis and response assessments in a phase 2 study of romidepsin in patients with relapsed or refractory peripheral T-cell lymphoma , 2015, Annals of oncology : official journal of the European Society for Medical Oncology.

[6]  Eric J. W. Visser,et al.  FDG PET/CT: EANM procedure guidelines for tumour imaging: version 2.0 , 2014, European Journal of Nuclear Medicine and Molecular Imaging.

[7]  R. Fisher,et al.  Role of imaging in the staging and response assessment of lymphoma: consensus of the International Conference on Malignant Lymphomas Imaging Working Group. , 2014, Journal of clinical oncology : official journal of the American Society of Clinical Oncology.

[8]  Bruce D Cheson,et al.  Recommendations for initial evaluation, staging, and response assessment of Hodgkin and non-Hodgkin lymphoma: the Lugano classification. , 2014, Journal of clinical oncology : official journal of the American Society of Clinical Oncology.

[9]  S. Pileri,et al.  Prognostic value of interim positron emission tomography in patients with peripheral T-cell lymphoma. , 2014, The oncologist.

[10]  H. Tilly,et al.  Pretherapy metabolic tumour volume is an independent predictor of outcome in patients with diffuse large B-cell lymphoma , 2014, European Journal of Nuclear Medicine and Molecular Imaging.

[11]  R. Advani,et al.  Objective responses in relapsed T-cell lymphomas with single-agent brentuximab vedotin. , 2014, Blood.

[12]  Alexandre Cochet,et al.  Baseline metabolic tumour volume is an independent prognostic factor in Hodgkin lymphoma , 2014, European Journal of Nuclear Medicine and Molecular Imaging.

[13]  R. Lhommel,et al.  Quantitative and qualitative analysis of metabolic response at interim positron emission tomography scan combined with International Prognostic Index is highly predictive of outcome in diffuse large B-cell lymphoma , 2014, Leukemia and Lymphoma.

[14]  Federica Fioroni,et al.  Metabolic tumour volumes measured at staging in lymphoma: methodological evaluation on phantom experiments and patients , 2014, European Journal of Nuclear Medicine and Molecular Imaging.

[15]  P. Gaulard,et al.  Pathology of peripheral T-cell lymphomas: where do we stand? , 2014, Seminars in hematology.

[16]  S. Son,et al.  Prognostic value of whole-body metabolic tumour volume and total lesion glycolysis measured on 18F-FDG PET/CT in patients with extranodal NK/T-cell lymphoma , 2013, European Journal of Nuclear Medicine and Molecular Imaging.

[17]  R. Gascoyne,et al.  Survival of patients with peripheral T-cell lymphoma after first relapse or progression: spectrum of disease and rare long-term survivors. , 2013, Journal of clinical oncology : official journal of the American Society of Clinical Oncology.

[18]  N. Schmitz,et al.  ESMO Consensus conferences: guidelines on malignant lymphoma. part 2: marginal zone lymphoma, mantle cell lymphoma, peripheral T-cell lymphoma. , 2013, Annals of oncology : official journal of the European Society for Medical Oncology.

[19]  R. Bouabdallah,et al.  Peripheral T-cell lymphomas: analysis of histology, staging and response to treatment of 208 cases at a single institution , 2013, Leukemia & lymphoma.

[20]  Seong-Jang Kim,et al.  Clinical value of metabolic tumor volume by PET/CT in extranodal natural killer/T cell lymphoma. , 2013, Leukemia research.

[21]  Matthew Greenwood,et al.  Results from a pivotal, open-label, phase II study of romidepsin in relapsed or refractory peripheral T-cell lymphoma after prior systemic therapy. , 2012, Journal of clinical oncology : official journal of the American Society of Clinical Oncology.

[22]  M. Lim Commentary on the WHO 2008 classification of neoplasms arising from histiocytic and other accessory cells , 2009, Journal of hematopathology.

[23]  D. Weisenburger,et al.  International peripheral T-cell and natural killer/T-cell lymphoma study: pathology findings and clinical outcomes. , 2008, Journal of clinical oncology : official journal of the American Society of Clinical Oncology.

[24]  Sigrid Stroobants,et al.  Revised response criteria for malignant lymphoma. , 2007, Journal of clinical oncology : official journal of the American Society of Clinical Oncology.

[25]  Sumithra J. Mandrekar,et al.  Finding Optimal Cutpoints for Continuous Covariates with Binary and Time-to-Event Outcomes , 2006 .

[26]  D. Rimm,et al.  X-Tile , 2004, Clinical Cancer Research.

[27]  E. Iannitto,et al.  Peripheral T-cell lymphoma unspecified (PTCL-U): a new prognostic model from a retrospective multicentric clinical study. , 2004, Blood.

[28]  P. Gaulard,et al.  Prognostic significance of T-cell phenotype in aggressive non-Hodgkin's lymphomas. Groupe d'Etudes des Lymphomes de l'Adulte (GELA). , 1998, Blood.