Haematologica (Nov 2019)

Utility of positron emission tomography-computed tomography in patients with chronic lymphocytic leukemia following B-cell receptor pathway inhibitor therapy

  • Anthony R. Mato,
  • William G. Wierda,
  • Matthew S. Davids,
  • Bruce D. Cheson,
  • Steven E. Coutre,
  • Michael Choi,
  • Richard R. Furman,
  • Leonard Heffner,
  • Paul M. Barr,
  • Herbert Eradat,
  • Sharanya M. Ford,
  • Lang Zhou,
  • Maria Verdugo,
  • Rod A. Humerickhouse,
  • Jalaja Potluri,
  • John C. Byrd

DOI
https://doi.org/10.3324/haematol.2018.207068
Journal volume & issue
Vol. 104, no. 11

Abstract

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The utility of positron emission tomography-computed tomography (PET-CT) in distinguishing Richter’s transformation versus chronic lymphocytic leukemia (CLL) progression after ibrutinib and/or idelalisib was assessed in a post hoc analysis of a phase II study of venetoclax. Patients underwent PET-CT at screening and were not enrolled/treated if Richter’s transformation was confirmed pathologically. Of 167 patients screened, 57 met criteria for biopsy after PET-CT. Of 35 patients who underwent biopsy, eight had Richter’s transformation, two had another malignancy, and 25 had CLL. A PET-CT maximum standardized uptake value (SUVmax) ≥10 had 71% sensitivity and 50% specificity for detecting Richter’s transformation [Odds Ratio (OR): 2.5, 95%CI: 0.4-15; P=0.318]. Response rate to venetoclax was similar for screening SUVmax