Baseline 18F-FDG Metabolic Tumor Volume Predicts Response to Rituximab Induction in Post-transplant Lymphoproliferative Disorders: A Multi-institutional Retrospective Study
Post-transplant lymphoproliferative disorder (PTLD) is a rare complication of immunosuppression. Sequential treatment is commonly proposed, combining induction with rituximab (R-induction) followed by either continuation of treatment or addition of chemotherapy depending on response. Response to R-i...
| Main Authors: | , , , , , , , , , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
Wiley
2023-02-01
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| Series: | HemaSphere |
| Online Access: | http://journals.lww.com/10.1097/HS9.0000000000000833 |
| _version_ | 1827333487440429056 |
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| author | David Morland Lukshe Kanagaratnam Fabrice Hubelé Elise Toussaint Sylvain Choquet Aurélie Kas Pierre-Ambroise Caquot Corinne Haioun Emmanuel Itti Stéphane Leprêtre Pierre Decazes Fontanet Bijou Paul Schwartz Caroline Jacquet Adrien Chauchet Julien Matuszak Nassim Kamar Pierre Payoux K-VIROGREF Study Group* Eric Durot |
| author_facet | David Morland Lukshe Kanagaratnam Fabrice Hubelé Elise Toussaint Sylvain Choquet Aurélie Kas Pierre-Ambroise Caquot Corinne Haioun Emmanuel Itti Stéphane Leprêtre Pierre Decazes Fontanet Bijou Paul Schwartz Caroline Jacquet Adrien Chauchet Julien Matuszak Nassim Kamar Pierre Payoux K-VIROGREF Study Group* Eric Durot |
| author_sort | David Morland |
| collection | DOAJ |
| description | Post-transplant lymphoproliferative disorder (PTLD) is a rare complication of immunosuppression. Sequential treatment is commonly proposed, combining induction with rituximab (R-induction) followed by either continuation of treatment or addition of chemotherapy depending on response. Response to R-induction, often assessed by CT scan, is a major predictor of overall survival (OS). The aim of the study was to analyze predictive factors of R-induction response, including total metabolic tumor volume (TMTV), and investigate the role of 18F-FDG PET/CT in response assessment. This retrospective multicenter study is based on patients with PTLD included in the K-VIROGREF cohort. Only patients treated by R-induction with a baseline 18F-FDG PET/CT were included. Response to R-induction was assessed by 18F-FDG PET/CT. The optimal threshold of TMTV for rituximab response was determined using receiver operating characteristic curves. Univariate and multivariate analyses were conducted to identify predictive factors of response. A total of 67 patients were included. Survival characteristics were similar to those previously reported: the complete response rate to R-induction was 30%, the 3-year OS estimate was 66%, and the treatment-related mortality was 4%. The optimal threshold for TMTV to predict R-induction response was 135 cm3. The response rate to R-induction was 38% in the 21 patients with TMTV ≥ 135 cm3 and 72% in the 46 patients with TMTV < 135 cm3. TMTV was a significant predictor of response, both at univariate and multivariate analyses (odd ratios = 3.71, P = 0.022). Baseline TMTV is predictive of response to R-induction. Early assessment of patient response is feasible with 18F-FDG PET/CT. |
| first_indexed | 2024-03-07T17:27:05Z |
| format | Article |
| id | doaj.art-543a51ba0dfe4d3f998930f3e323fe57 |
| institution | Directory Open Access Journal |
| issn | 2572-9241 |
| language | English |
| last_indexed | 2024-03-07T17:27:05Z |
| publishDate | 2023-02-01 |
| publisher | Wiley |
| record_format | Article |
| series | HemaSphere |
| spelling | doaj.art-543a51ba0dfe4d3f998930f3e323fe572024-03-02T18:52:09ZengWileyHemaSphere2572-92412023-02-0172e83310.1097/HS9.0000000000000833202302000-00004Baseline 18F-FDG Metabolic Tumor Volume Predicts Response to Rituximab Induction in Post-transplant Lymphoproliferative Disorders: A Multi-institutional Retrospective StudyDavid Morland0Lukshe Kanagaratnam1Fabrice Hubelé2Elise Toussaint3Sylvain Choquet4Aurélie Kas5Pierre-Ambroise Caquot6Corinne Haioun7Emmanuel Itti8Stéphane Leprêtre9Pierre Decazes10Fontanet Bijou11Paul Schwartz12Caroline Jacquet13Adrien Chauchet14Julien Matuszak15Nassim Kamar16Pierre Payoux17K-VIROGREF Study Group*Eric Durot181 Médecine Nucléaire, Institut Godinot, Reims, France5 Unité d’Aide Méthodologique, Pôle Recherche et Santé Publique, CHU de Reims, Reims, France6 Médecine Nucléaire, CHU de Strasbourg, ICANS, Strasbourg, France7 Hématologie, CHU de Strasbourg, ICANS, Strasbourg, France8 Hématologie, CHU Pitié-Salpêtrière Charles Foix, Sorbonne Université, AP-HP, Paris, France9 Médecine Nucléaire, CHU Pitié-Salpêtrière Charles Foix, Sorbonne Université, AP-HP, Paris, France1 Médecine Nucléaire, Institut Godinot, Reims, France10 Hématologie, CHU Henri Mondor, AP-HP, Créteil, France11 Médecine Nucléaire, CHU Henri Mondor, AP-HP, Créteil, France12 Inserm U1245 et Département d’Hématologie, Centre Henri Becquerel et Normandie Univ, UNIROUEN, Rouen, France13 Médecine Nucléaire, Centre Henri Becquerel, Rouen, France14 Hématologie, Institut Bergonié, Bordeaux, France15 Médecine Nucléaire, Institut Bergonié, Bordeaux, France16 Hématologie, CHU de Nancy, France17 Hématologie, CHU de Besançon, France18 Médecine Nucléaire, CHU de Besançon, France19 Néphrologie et transplantation d’organes, CHU Rangueil, Toulouse, France20 Médecine Nucléaire, CHU de Toulouse, France21 Hématologie clinique, CHU de Reims, FrancePost-transplant lymphoproliferative disorder (PTLD) is a rare complication of immunosuppression. Sequential treatment is commonly proposed, combining induction with rituximab (R-induction) followed by either continuation of treatment or addition of chemotherapy depending on response. Response to R-induction, often assessed by CT scan, is a major predictor of overall survival (OS). The aim of the study was to analyze predictive factors of R-induction response, including total metabolic tumor volume (TMTV), and investigate the role of 18F-FDG PET/CT in response assessment. This retrospective multicenter study is based on patients with PTLD included in the K-VIROGREF cohort. Only patients treated by R-induction with a baseline 18F-FDG PET/CT were included. Response to R-induction was assessed by 18F-FDG PET/CT. The optimal threshold of TMTV for rituximab response was determined using receiver operating characteristic curves. Univariate and multivariate analyses were conducted to identify predictive factors of response. A total of 67 patients were included. Survival characteristics were similar to those previously reported: the complete response rate to R-induction was 30%, the 3-year OS estimate was 66%, and the treatment-related mortality was 4%. The optimal threshold for TMTV to predict R-induction response was 135 cm3. The response rate to R-induction was 38% in the 21 patients with TMTV ≥ 135 cm3 and 72% in the 46 patients with TMTV < 135 cm3. TMTV was a significant predictor of response, both at univariate and multivariate analyses (odd ratios = 3.71, P = 0.022). Baseline TMTV is predictive of response to R-induction. Early assessment of patient response is feasible with 18F-FDG PET/CT.http://journals.lww.com/10.1097/HS9.0000000000000833 |
| spellingShingle | David Morland Lukshe Kanagaratnam Fabrice Hubelé Elise Toussaint Sylvain Choquet Aurélie Kas Pierre-Ambroise Caquot Corinne Haioun Emmanuel Itti Stéphane Leprêtre Pierre Decazes Fontanet Bijou Paul Schwartz Caroline Jacquet Adrien Chauchet Julien Matuszak Nassim Kamar Pierre Payoux K-VIROGREF Study Group* Eric Durot Baseline 18F-FDG Metabolic Tumor Volume Predicts Response to Rituximab Induction in Post-transplant Lymphoproliferative Disorders: A Multi-institutional Retrospective Study HemaSphere |
| title | Baseline 18F-FDG Metabolic Tumor Volume Predicts Response to Rituximab Induction in Post-transplant Lymphoproliferative Disorders: A Multi-institutional Retrospective Study |
| title_full | Baseline 18F-FDG Metabolic Tumor Volume Predicts Response to Rituximab Induction in Post-transplant Lymphoproliferative Disorders: A Multi-institutional Retrospective Study |
| title_fullStr | Baseline 18F-FDG Metabolic Tumor Volume Predicts Response to Rituximab Induction in Post-transplant Lymphoproliferative Disorders: A Multi-institutional Retrospective Study |
| title_full_unstemmed | Baseline 18F-FDG Metabolic Tumor Volume Predicts Response to Rituximab Induction in Post-transplant Lymphoproliferative Disorders: A Multi-institutional Retrospective Study |
| title_short | Baseline 18F-FDG Metabolic Tumor Volume Predicts Response to Rituximab Induction in Post-transplant Lymphoproliferative Disorders: A Multi-institutional Retrospective Study |
| title_sort | baseline 18f fdg metabolic tumor volume predicts response to rituximab induction in post transplant lymphoproliferative disorders a multi institutional retrospective study |
| url | http://journals.lww.com/10.1097/HS9.0000000000000833 |
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