Clinical Research Papers:
18 FDG-PET/CT for prognostic stratification of patients with multiple myeloma relapse after stem cell transplantation
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Constantin Lapa1*, Katharina Lückerath1*, Uwe Malzahn2,4, Samuel Samnick1, Herrmann Einsele3, Andreas K. Buck1 , Ken Herrmann1 and Stefan Knop3
1 Department of Nuclear Medicine,Medical Center, University of Würzburg, Würzburg
2 Institute of Clinical Epidemiology and Biometry, University of Würzburg, Würzburg
3 Department of Hematology and Oncology,Medical Center, University of Würzburg, Würzburg
4 Clinical Trial Center Würzburg, University Hospital Würzburg, Würzburg
* These authors contributed equally to this work
Ken Herrmann, email:
Keywords: Multiple myeloma, molecular imaging, FDG-PET/CT
Received: June 30, 2014 Accepted: July 31, 2014 Published: July 31, 2014
The aim of this study was to investigate the prognostic value of 18F-fluoro-deoxyglucose positron emission tomography–computed tomography (18F-FDG-PET/CT) in 37 patients with a history of multiple myeloma (MM) and suspected or confirmed recurrence after stem cell transplantation (SCT). All patients had been heavily pre-treated. Time to progression (TTP) and overall survival (OS) were correlated to a number of different PET-derived as well as clinical parameters. Impact on patient management was assessed.
Absence of FDG-avid MM foci was a positive prognostic factor for both TTP and OS (p<0.01). Presence of >10 focal lesions correlated with both TTP (p<0.01) and OS (p<0.05). Interestingly, presence of >10 lesions in the appendicular skeleton proved to have the strongest association with disease progression. Intensity of glucose uptake and presence of extramedullary disease were associated with shorter TTP (p=0.037 and p=0.049, respectively). Manifestations in soft tissue structures turned out to be a strong negative predictor for both, TTP and OS (p<0.01, respectively). PET resulted in a change of management in 30% of patients.
Our data underline the prognostic value of 18F-FDG-PET/CT in MM patients also in the setting of post-SCT relapse. PET/CT has a significant impact on patient management.
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