Haematologica (Jul 2020)

Pre-treatment maximum standardized uptake value predicts outcome after frontline therapy in patients with advanced stage follicular lymphoma

  • Paolo Strati,
  • Mohamed Amin Ahmed,
  • Nathan H. Fowler,
  • Loretta J. Nastoupil,
  • Felipe Samaniego,
  • Luis E. Fayad,
  • Fredrick B. Hagemeister,
  • Jorge E. Romaguera,
  • Alma Rodriguez,
  • Michael Wang,
  • Jason R. Westin,
  • Chan Cheah,
  • Mansoor Noorani,
  • Lei Feng,
  • Richard E. Davis,
  • Sattva S. Neelapu

DOI
https://doi.org/10.3324/haematol.2019.230649
Journal volume & issue
Vol. 105, no. 7

Abstract

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The impact of pre-treatment maximum standardized uptake value (SUVmax) on the outcome of follicular lymphoma (FL) following specific frontline regimens has not been explored. We performed a retrospective analysis of 346 patients with advanced stage follicular lymphoma (FL) without histological evidence of transformation, and analyzed the impact of SUVmax on outcome after frontline therapy. Fifty-two (15%) patients had a SUVmax >18, and a large lymph node ≥6 cm was the only factor associating with SUVmax >18 on multivariate analysis (odds ratio 2.7, 95% confidence interval [CI]: 1.3-5.3, P=0.006). The complete response rate was significantly lower among patients treated with non-anthracycline-based regimens if SUVmax was >18 (45% vs. 92%, P18 was associated with significantly shorter progression-free survival among patients treated with non-anthracycline-based regimens (77 months vs. not reached, P=0.02), but not among patients treated with R-CHOP (P=0.73). SUVmax >18 associated with shorter overall survival (OS) both in patients treated with R-CHOP (8-year OS 70% vs. 90%, P=0.02) and non-anthracycline-based frontline regimens (8-year OS 50% vs. 85%, P=0.001). In conclusion, pre-treatment PET scan has prognostic and predictive value in patients with advanced stage FL receiving frontline treatment.