The impact of baseline and interim PET/CT parameters on clinical outcome in patients with diffuse large B cell lymphoma

Abstract

mg administered during two or three annual cycles (12 mg or 24 mg, 3 times a week). The shorter time to ITP development observed in our study may be related to the different cumulative dose and to the different schedule of drug administration.It has been previously suggested that ITP secondary to lymphoproliferative disorders could be ascribed to autoreactive non-malignant B-cell clones, favored by the loss of immune tolerance due to T-cell dysfunction and/or inappropriate pathological (auto)antigen presentation by CLL cells [16,17]. During alemtuzumab treatment, immune-dysregulation of T lymphocytes may further favor autoimmunity.In conclusion, while reporting for the first time the association between lowdose alemtuzumab treatment and ITP in a cohort of CLL patients, we would also suggest to maintain a high level of vigilance and to strongly consider routine monitoring for ITP in patients treated with this agent for any pathologic condition. MethodsWe retrospectively analyzed a cohort of 64 patients affected by CLL, diagnosed according to NCIWG-CLL criteria and referred to the Hematology-BMT Unit of the Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan between 2003 and. Median age of patients was 68 years (range: 40-83 years).Patients had been treated with low-dose Alemtuzumab, defined as a total weekly dose lower than 45 mg and a cumulative dose inferior to 600 mg, administered for up to 18 weeks [18,19,20].The diagnosis of ITP was based on (1) an otherwise unexplained, rapid (<2 weeks) and severe fall (at least half of the initial level and below 100 3 10 9 /L) of the platelet counts; (2) a normal or augmented number of megakaryocytes in the bone marrow; (3) no or limited (not palpable) splenomegaly, and (4) no cytotoxic treatment in the last month except for alemtuzumab. We also evaluated assays for antibodies to specific platelet glycoproteins, even if they are not routinely recommended, as platelet-associated IgG is elevated in both immune and non-immune thrombocytopenia [21]. Conflict of interest: Nothing to report. A.C., G.R., C.V., and F.R. designed the research study; F.M., G.G., G.R., A.G., F.B., and F.G. performed the research; F.M., G.G., A.G., and A.P. analyzed the data; A.C., G.R., F.M., G.G., C.V. wrote the paper. The impact of baseline and interim PET/CT parameters on clinical outcome in patients with diffuse large B cell lymphoma F-FDG PET/CT as a tool for guidance in risk stratification in patients with aggressive non-Hodgkin's lymphoma (NHL). Here, we analyzed the predictive value of various PET/CT parameters in patients with DLBCL. Particularly, we were interested in patients with an IPI score of 1, 2, or 3, whose prognosis are confusing. Between Jul 2008 and Feb 2010, a total of 100 patients (including 57 patients with an IPI score of 1-3) who were treated with R-CHOP for DLBCL, and had assessable PET/CT parameters were analyzed in this study. Absolute value of SUV max , SUV sum (sum of SUV max ) and TLG sum (SUV mean x Volume meta ) from baseline and interim PET/CT, and DS...

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