The value of &lt;sup&gt;18&lt;/sup&gt;F‑FDG PET/CT in the prediction of clinical outcomes of patients with acute leukemia treated with allogeneic hematopoietic stem cell transplantation

Zhao, Zixuan; Zhou, Yeye; Wang, Jing; Zhang, Tongtong; Li, Jihui; Zhang, Bin; Li, Qingru; Deng, Shengming

doi:10.3892/ol.2020.12036

Cited by 5 publications

(7 citation statements)

References 41 publications

(67 reference statements)

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“…Our results showed that for the allogeneic SCT group, the possibility of false positives should also be considered when FDG-avid foci appeared outside the sites of the original disease, suggesting that FDG-avid foci that appeared outside the sites of the original disease should be viewed with caution. One of our previous studies on acute leukemia patients treated with allo-SCT [ 45 ] has shown that FDG-avid lymph nodes >1.5 cm were not significantly associated with OS and DFS in multivariate analysis. This may be related to not considering other factors, such as if the FDG-avid foci appeared outside the sites of the original disease.…”

Section: Discussionmentioning

confidence: 99%

Analysis of Positive Results of 18F-FDG PET/CT Imaging after Hematopoietic Stem Cell Transplantation in Lymphoma

et al. 2023

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Purpose: The purpose of this study was to differentiate between false-positive and true-positive positron emission tomography (PET) results after hematopoietic stem cell transplantation (SCT) for lymphoma involvement by analyzing several clinical variables and specific imaging features. Patients and Methods: Patients with lymphoma who received SCT and underwent post-transplantation 18F-FDG PET/CT scans between January 2013 and April 2021 at our institution were included. Associations between PET positivity and related clinical information were assessed using t-tests and χ2 tests. The significance of variables differentiating benign lesions from malignant FDG-avid lesions was evaluated by logistic regression analysis. Survival probabilities were derived from Kaplan-Meier curves and compared using the log-rank test. Results: A total of 185 patients (235 post-transplantation PET/CT scans) were enrolled in our present study. Compared with those with true-positive PET results, patients with false-positive PET results exhibited a better prognosis. For the autologous SCT group, false-positive cases were more commonly seen when FDG-avid foci appeared outside the sites of the original disease (p = 0.004), and the integrated CT imaging showed negative results (p = 0.000). In multivariate logistic regression analysis, integrated CT results were the only significant factor. For the allogeneic SCT group, false-positive cases were significantly more commonly seen when DS = 4 (p = 0.046), FDG-avid foci appeared outside the sites of the original disease (p = 0.022), and the integrated CT imaging showed negative results (p = 0.001). In a multivariate logistic regression analysis, whether FDG-avid foci were in the sites of the original disease and integrated CT results were both significant factors. Conclusion: False-positive FDG uptake in post-transplantation PET was not uncommon. Several variables could provide an important reference to differentiate false-positive from true-positive post-SCT PET results for lymphoma involvement. Trial registration number: ChiCTR2300067355.

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Section: Discussionmentioning

confidence: 99%

Analysis of Positive Results of 18F-FDG PET/CT Imaging after Hematopoietic Stem Cell Transplantation in Lymphoma

et al. 2023

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“…Zhao et al . analyzed a total of 79 scans from 72 patients with acute leukemia and found that the presence of extranodal, extramedullary, and extra-splenic sites was identified as an independent prognostic indicator [104]. Patients with this disease extent pattern were shown to have a lower OS rate in both univariate and multivariate survival analyses [104].…”

Section: Other Utilitiesmentioning

confidence: 99%

PET/CT in leukemia: utility and future directions

Al-Ibraheem,

Allouzi,

Abdlkadir

et al. 2024

Nuclear Medicine Communications

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2-Deoxy-2-[18F]fluoro-d-glucose PET/computed tomography ([18F]FDG PET/CT) has proven to be a sensitive method for the detection and evaluation of hematologic malignancies, especially lymphoma. The increasing incidence and mortality rates of leukemia have raised significant concerns. Through the utilization of whole-body imaging, [18F]FDG PET/CT provides a thorough assessment of the entire bone marrow, complementing the limited insights provided by biopsy samples. In this regard, [18F]FDG PET/CT has the ability to assess diverse types of leukemia The utilization of [18F]FDG PET/CT has been found to be effective in evaluating leukemia spread beyond the bone marrow, tracking disease relapse, identifying Richter’s transformation, and assessing the inflammatory activity associated with acute graft versus host disease. However, its role in various clinical scenarios in leukemia remains unacknowledged. Despite their less common use, some novel PET/CT radiotracers are being researched for potential use in specific scenarios in leukemia patients. Therefore, the objectives of this review are to provide a thorough assessment of the current applications of [18F]FDG PET/CT in the staging and monitoring of leukemia patients, as well as the potential for an expanding role of PET/CT in leukemia patients.

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“…Zhao et al retrospectively analysed findings from 18 F-FDG-PET/CT performed before and/or after HSCT for acute leukaemia in 72 patients (55). The study included various types of leukaemia and evaluated bone marrow, lymph nodes, spleen and extramedullary disease.…”

Section: Other Techniques To Evaluate Residual Disease 18 F-fdg-pet/ctmentioning

confidence: 99%

Minimal Residual Disease Prior to and After Haematopoietic Stem Cell Transplantation in Children and Adolescents With Acute Lymphoblastic Leukaemia: What Level of Negativity Is Relevant?

et al. 2021

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Minimal residual disease (MRD) assessment plays a central role in risk stratification and treatment guidance in paediatric patients with acute lymphoblastic leukaemia (ALL). As such, MRD prior to haematopoietic stem cell transplantation (HSCT) is a major factor that is independently correlated with outcome. High burden of MRD is negatively correlated with post-transplant survival, as both the risk of leukaemia recurrence and non-relapse mortality increase with greater levels of MRD. Despite growing evidence supporting these findings, controversies still exist. In particular, it is still not clear whether multiparameter flow cytometry and real-time quantitative polymerase chain reaction, which is used to recognise immunoglobulin and T-cell receptor gene rearrangements, can be employed interchangeably. Moreover, the higher sensitivity in MRD quantification offered by next-generation sequencing techniques may further refine the ability to stratify transplant-associated risks. While MRD quantification from bone marrow prior to HSCT remains the state of the art, heavily pre-treated patients may benefit from additional staging, such as using 18F-fluorodeoxyglucose positron emission tomography/computed tomography to detect focal residues of disease. Additionally, the timing of MRD detection (i.e., immediately before administration of the conditioning regimen or weeks before) is a matter of debate. Pre-transplant MRD negativity has previously been associated with superior outcomes; however, in the recent For Omitting Radiation Under Majority age (FORUM) study, pre-HSCT MRD positivity was associated with neither relapse risk nor survival. In this review, we discuss the level of MRD that may require pre-transplant therapy intensification, risking time delay and complications (as well as losing the window for HSCT if disease progression occurs), as opposed to an adapted post-transplant strategy to achieve long-term remission. Indeed, MRD monitoring may be a valuable tool to guide individualised treatment decisions, including tapering of immunosuppression, cellular therapies (such as donor lymphocyte infusions) or additional immunotherapy (such as bispecific T-cell engagers or chimeric antigen receptor T-cell therapy).

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The value of <sup>18</sup>F‑FDG PET/CT in the prediction of clinical outcomes of patients with acute leukemia treated with allogeneic hematopoietic stem cell transplantation

Cited by 5 publications

References 41 publications

Analysis of Positive Results of 18F-FDG PET/CT Imaging after Hematopoietic Stem Cell Transplantation in Lymphoma

Analysis of Positive Results of 18F-FDG PET/CT Imaging after Hematopoietic Stem Cell Transplantation in Lymphoma

PET/CT in leukemia: utility and future directions

Minimal Residual Disease Prior to and After Haematopoietic Stem Cell Transplantation in Children and Adolescents With Acute Lymphoblastic Leukaemia: What Level of Negativity Is Relevant?

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