Prognostic Significance of PET/CT in Patients with Chronic Lymphocytic Leukemia (CLL) Treated with Frontline Chemoimmunotherapy
The role of positron emission tomography/computed tomography (PET/CT) in identifying Richter Syndrome (RS) is well established, while its impact on the survival of patients with chronic lymphocytic leukemia (CLL) has been less explored. The clinical characteristics and PET/CT data of 40 patients wit...
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doaj-3cadaca9e9f34385b286681313f6f4052020-11-25T03:01:13ZengMDPI AGCancers2072-66942020-07-01121773177310.3390/cancers12071773Prognostic Significance of PET/CT in Patients with Chronic Lymphocytic Leukemia (CLL) Treated with Frontline ChemoimmunotherapyMarika Porrazzo0Emanuele Nicolai1Mara Riminucci2Candida Vitale3Marta Coscia4Lorenzo De Paoli5Angela Rago6Giulia Buscicchio7Giacomo Maestrini8Silvio Ligia9Alessio Di Prima10Alessandro Corsi11Roberto Caronna12Gianluca Gaidano13Francesca Romana Mauro14Hematology, Department of Translational and Precision Medicine, Sapienza University, Via Benevento 6, 00161 Rome, ItalyInstitute of Diagnostic and Nuclear Research, IRCCS SDN, 80143 Naples, ItalyDepartment of Molecular Medicine, “Sapienza” University of Rome, 00161 Roma, ItalyDivision of Hematology, A.O.U. Città della Salute e della Scienza di Torino and Department of Molecular Biotechnology and Health Sciences, University of Turin, 10124 Torino, ItalyDivision of Hematology, A.O.U. Città della Salute e della Scienza di Torino and Department of Molecular Biotechnology and Health Sciences, University of Turin, 10124 Torino, ItalyDivision of Hematology, Department of Translational Medicine, University of Eastern Piedmont, 28100 Novara, ItalyUOSD Hematology, ASL Roma 1, 00193 Rome, ItalyDepartment of Psychology, Catholic University of the Sacred-Heart, 20123 Milan, ItalyHematology, Department of Translational and Precision Medicine, Sapienza University, Via Benevento 6, 00161 Rome, ItalyHematology, Department of Translational and Precision Medicine, Sapienza University, Via Benevento 6, 00161 Rome, ItalyHematology, Department of Translational and Precision Medicine, Sapienza University, Via Benevento 6, 00161 Rome, ItalyDepartment of Molecular Medicine, “Sapienza” University of Rome, 00161 Roma, ItalyDepartment of Surgical Sciences, Sapienza University, 00161 Rome, ItalyDivision of Hematology, Department of Translational Medicine, University of Eastern Piedmont, 28100 Novara, ItalyHematology, Department of Translational and Precision Medicine, Sapienza University, Via Benevento 6, 00161 Rome, ItalyThe role of positron emission tomography/computed tomography (PET/CT) in identifying Richter Syndrome (RS) is well established, while its impact on the survival of patients with chronic lymphocytic leukemia (CLL) has been less explored. The clinical characteristics and PET/CT data of 40 patients with a biopsy-proven CLL who required frontline chemoimmunotherapy, FCR (fludarabine, cyclophosphamide, rituximab) in 20 patients, BR (bendamustine, rituximab) in 20, were retrospectively analyzed. Standardized uptake volume (SUV<sub>max</sub>) values ≥ 5 were observed more frequently in patients with deletion 11q (<i>p</i> = 0.006) and biopsies characterized by a rate of Ki67 positive cells ≥ 30% (<i>p</i> = 0.02). In the multivariate analysis, the presence of large and confluent PCs emerged as the only factor with a negative impact on progression-free survival (PFS), and overall survival (OS). Deletion 11q also revealed a significant and independent effect on PFS. SUV<sub>max</sub> values ≥ 5 showed no statistical impact on PFS while in multivariate analysis, they revealed a significant adverse impact on OS (median survival probability not reached vs. 56 months; <i>p</i> = 0.002). Moreover, patients with higher SUV<sub>max</sub> values more frequently developed Richter Syndrome (<i>p</i> = 0.015). Our results show that higher SUV<sub>max</sub> values identify CLL patients with a pronounced rate of proliferating cells in the lymph-node compartment, inferior survival, and an increased risk of developing RS.https://www.mdpi.com/2072-6694/12/7/1773chronic lymphocytic leukemiaPET/CTsurvival |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Marika Porrazzo Emanuele Nicolai Mara Riminucci Candida Vitale Marta Coscia Lorenzo De Paoli Angela Rago Giulia Buscicchio Giacomo Maestrini Silvio Ligia Alessio Di Prima Alessandro Corsi Roberto Caronna Gianluca Gaidano Francesca Romana Mauro |
spellingShingle |
Marika Porrazzo Emanuele Nicolai Mara Riminucci Candida Vitale Marta Coscia Lorenzo De Paoli Angela Rago Giulia Buscicchio Giacomo Maestrini Silvio Ligia Alessio Di Prima Alessandro Corsi Roberto Caronna Gianluca Gaidano Francesca Romana Mauro Prognostic Significance of PET/CT in Patients with Chronic Lymphocytic Leukemia (CLL) Treated with Frontline Chemoimmunotherapy Cancers chronic lymphocytic leukemia PET/CT survival |
author_facet |
Marika Porrazzo Emanuele Nicolai Mara Riminucci Candida Vitale Marta Coscia Lorenzo De Paoli Angela Rago Giulia Buscicchio Giacomo Maestrini Silvio Ligia Alessio Di Prima Alessandro Corsi Roberto Caronna Gianluca Gaidano Francesca Romana Mauro |
author_sort |
Marika Porrazzo |
title |
Prognostic Significance of PET/CT in Patients with Chronic Lymphocytic Leukemia (CLL) Treated with Frontline Chemoimmunotherapy |
title_short |
Prognostic Significance of PET/CT in Patients with Chronic Lymphocytic Leukemia (CLL) Treated with Frontline Chemoimmunotherapy |
title_full |
Prognostic Significance of PET/CT in Patients with Chronic Lymphocytic Leukemia (CLL) Treated with Frontline Chemoimmunotherapy |
title_fullStr |
Prognostic Significance of PET/CT in Patients with Chronic Lymphocytic Leukemia (CLL) Treated with Frontline Chemoimmunotherapy |
title_full_unstemmed |
Prognostic Significance of PET/CT in Patients with Chronic Lymphocytic Leukemia (CLL) Treated with Frontline Chemoimmunotherapy |
title_sort |
prognostic significance of pet/ct in patients with chronic lymphocytic leukemia (cll) treated with frontline chemoimmunotherapy |
publisher |
MDPI AG |
series |
Cancers |
issn |
2072-6694 |
publishDate |
2020-07-01 |
description |
The role of positron emission tomography/computed tomography (PET/CT) in identifying Richter Syndrome (RS) is well established, while its impact on the survival of patients with chronic lymphocytic leukemia (CLL) has been less explored. The clinical characteristics and PET/CT data of 40 patients with a biopsy-proven CLL who required frontline chemoimmunotherapy, FCR (fludarabine, cyclophosphamide, rituximab) in 20 patients, BR (bendamustine, rituximab) in 20, were retrospectively analyzed. Standardized uptake volume (SUV<sub>max</sub>) values ≥ 5 were observed more frequently in patients with deletion 11q (<i>p</i> = 0.006) and biopsies characterized by a rate of Ki67 positive cells ≥ 30% (<i>p</i> = 0.02). In the multivariate analysis, the presence of large and confluent PCs emerged as the only factor with a negative impact on progression-free survival (PFS), and overall survival (OS). Deletion 11q also revealed a significant and independent effect on PFS. SUV<sub>max</sub> values ≥ 5 showed no statistical impact on PFS while in multivariate analysis, they revealed a significant adverse impact on OS (median survival probability not reached vs. 56 months; <i>p</i> = 0.002). Moreover, patients with higher SUV<sub>max</sub> values more frequently developed Richter Syndrome (<i>p</i> = 0.015). Our results show that higher SUV<sub>max</sub> values identify CLL patients with a pronounced rate of proliferating cells in the lymph-node compartment, inferior survival, and an increased risk of developing RS. |
topic |
chronic lymphocytic leukemia PET/CT survival |
url |
https://www.mdpi.com/2072-6694/12/7/1773 |
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