Prognostic value of [18F]FDG-PET/CT in multiple myeloma patients before and after allogeneic hematopoietic cell transplantation

Stolzenburg A, Lueckerath K, Samnick S, Speer M, Kneer K, Schmid JS, Grigoleit GU, Hofmann S, Beer AJ, Bunjes D, Knop S, Buck AK, Einsele H, Lapa C (2018)

Publication Type: Journal article

Publication year: 2018

Journal

European Journal of Nuclear Medicine and Molecular Imaging Springer Verlag (Germany)

Book Volume: 45

Pages Range: 1694-1704

Journal Issue: 10

DOI: 10.1007/s00259-018-3997-0

Abstract

Purpose: Despite improved treatment options, multiple myeloma (MM) remains an incurable disease. The aim of this study was to investigate the prognostic value of positron emission tomography/computed tomography (PET/CT) using 18F-2’-deoxy-2’-fluorodeoxyglucose ([18F]FDG) in MM patients shortly before and ~100 days after allogeneic hematopoietic cell transplantation (allo-HCT). Methods: In this retrospective analysis, we evaluated [18F]FDG-PET/CT-scans of 45 heavily pre-treated MM patients before and 27 patients after scheduled allo-HCT. All scans were qualitatively and semi-quantitatively assessed for the presence of active disease. Serological response was recorded according to International Myeloma Working Group (IMWG) criteria. Progression-free (PFS) and overall survival (OS) were correlated with different PET/CT-derived parameters, such as presence, number and maximum standardized uptake value (SUVmax) of focal myeloma lesions. The impact of extramedullary disease on patient outcome was also assessed. Results: PET/CT negativity -prior to or following allo-HCT- was a favorable prognostic factor for progression-free and overall survival (both, PFS and OS: pre-HSCT p < 0.001, post-HCT p < 0.005). High FDG-uptake (SUVmax > 6.5) revealed a significantly shortened survival compared to patients with a lower SUVmax (<6.5) (OS, 5.0 ± 1.1 m vs. not reached - longest 122.0 m; p < 0.001). Moreover, our data prove that a higher number (>3) of focal lesions (pre-HCT: both PFS and OS: p < 0.001; post-HCT PFS: p < 0.001, OS: p = 0.139) as well as the presence of extramedullary disease serve as adverse prognostic factors prior to and after allo-HCT. At response assessment after allo-HCT, [18F]FDG-PET/CT had a complementary value in prognostication in addition to IMWG criteria alone. Conclusion: [18F]FDG-PET/CT before and shortly after allogeneic HCT is a powerful predictor for progression-free and overall survival in MM patients.

Involved external institutions

Universitätsklinikum Würzburg DE Germany (DE) Universität Ulm DE Germany (DE)

How to cite

APA:

Stolzenburg, A., Lueckerath, K., Samnick, S., Speer, M., Kneer, K., Schmid, J.-S.,... Lapa, C. (2018). Prognostic value of [18F]FDG-PET/CT in multiple myeloma patients before and after allogeneic hematopoietic cell transplantation. European Journal of Nuclear Medicine and Molecular Imaging, 45(10), 1694-1704. https://doi.org/10.1007/s00259-018-3997-0

MLA:

Stolzenburg, Antje, et al. "Prognostic value of [18F]FDG-PET/CT in multiple myeloma patients before and after allogeneic hematopoietic cell transplantation." European Journal of Nuclear Medicine and Molecular Imaging 45.10 (2018): 1694-1704.

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