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Ng DZ, Lee CY, Lam WW, Tong AK, Tan SH, Khoo LP, Tan YH, Chiang J, Chang EW, Chan JY, Poon EY, Somasundaram N, Farid H Rashid M, Tao M, Lim ST, Yang VS. Prognostication of diffuse large B-cell lymphoma patients with Deauville score of 3 or 4 at end-of-treatment PET evaluation: a comparison of the Deauville 5-point scale and the ΔSUVmax method. Leuk Lymphoma 2021; 63:256-259. [PMID: 34665693 DOI: 10.1080/10428194.2021.1992624] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
Diffuse large B-cell lymphoma is treated with anti-CD 20 and multi-drug chemotherapy for cure. Positron emission tomography (PET) scans are performed at end of treatment (EOT) to assess response. EOT Deauville scores (DS) are equivocal for treatment response in some situations, requiring physicians to determine the need for further investigations or treatment. Studies have suggested the delta maximum standardised uptake value (ΔSUVmax) to be superior to DS for assessment of metabolic response at interim PET, although its use at EOT PET, especially in cases of equivocal response, has yet to be established. We investigated whether ΔSUVmax could better discriminate prognosis than DS 3 or 4 at EOT. ΔSUVmax did not outperform DS. Combination of DS 3 and International Prognostic Index (IPI) <3 selects for patients with extremely low risk of disease progression (HR 0.06, 95% CI 0.01 to 0.62, p 0.018) compared to DS 4 and IPI ≥3.
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Affiliation(s)
- David Z Ng
- Internal Medicine Residency, SingHealth Services, Singapore
| | - Chuan Yaw Lee
- Internal Medicine Residency, SingHealth Services, Singapore
| | - Winnie W Lam
- Department of Nuclear Medicine and Molecular Imaging, Singapore General Hospital, Singapore.,Duke-NUS Medical School, Radiological Sciences Academic Clinical Programme, Singapore
| | - Aaron K Tong
- Department of Nuclear Medicine and Molecular Imaging, Singapore General Hospital, Singapore.,Duke-NUS Medical School, Radiological Sciences Academic Clinical Programme, Singapore
| | - Sze Huey Tan
- Biostatistics Unit, National Cancer Centre Singapore, Singapore
| | - Lay Poh Khoo
- Division of Medical Oncology, National Cancer Centre Singapore, Singapore
| | - Ya Hwee Tan
- Division of Medical Oncology, National Cancer Centre Singapore, Singapore
| | - Jianbang Chiang
- Division of Medical Oncology, National Cancer Centre Singapore, Singapore
| | - Esther W Chang
- Division of Medical Oncology, National Cancer Centre Singapore, Singapore
| | - Jason Y Chan
- Division of Medical Oncology, National Cancer Centre Singapore, Singapore.,Duke-NUS Medical School, Oncology Academic Clinical Programme, Singapore
| | - Eileen Y Poon
- Division of Medical Oncology, National Cancer Centre Singapore, Singapore
| | | | | | - Miriam Tao
- Division of Medical Oncology, National Cancer Centre Singapore, Singapore
| | - Soon Thye Lim
- Division of Medical Oncology, National Cancer Centre Singapore, Singapore.,Duke-NUS Medical School, Oncology Academic Clinical Programme, Singapore
| | - Valerie S Yang
- Division of Medical Oncology, National Cancer Centre Singapore, Singapore.,Duke-NUS Medical School, Oncology Academic Clinical Programme, Singapore.,Translational Precision Oncology Laboratory, Institute of Molecular & Cell Biology, A*STAR, Singapore
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