a8434574b357b53d454abeb830509d31 cancers-16-04189.pdf cd5d4259f993eeba647c35eb654aeaf69c27a5d0 cancers-16-04189.pdf 1c29fc8fabdde027a9a00c1c24960c213e07d236d05877001f4c3b2d7454cb34 cancers-16-04189.pdf Title: The Value of Bone Marrow Assessment by FDG PET/CT, Biopsy and Aspirate in the Upfront Evaluation of Mantle Cell Lymphoma: A Nationwide Cohort Study Subject: Background: Assessment of bone marrow infiltration (BMI) is part of the initial staging of mantle cell lymphoma (MCL), although BMI evaluated by biopsy (BMB) is not considered significant in the MIPI scales, and standardized recommendations remain lacking. Objectives: To evaluate the accuracy and prognostic impact of BMI assessed by PET/CT and BMB in a large series of MCL patients. Methods: We deconstructed the IPI-NCCN, MIPI, and MIPI-c indices and considered BMI as positive if indicated by a BMB, PET/CT scan, or a combination of both. Results: In the total cohort (n = 148), 110 patients had BMI detected by BMB and 33 by PET/CT. The sensitivity of BMB was higher than that of PET/CT (94.8% vs. 28.4%), as were its negative predictive value (84.2% vs. 27.8%) and accuracy (95.9% vs. 43.9%). In the total cohort, BMI detected by PET/CT showed a significant predictive value for PFS (p = 0.027), while BMB demonstrated independent prognostic value only in combination with PET/CT (p = 0.025). Among intensively treated patients (n = 128), PET/CT had significant clinical impact on PFS (p = 0.030), and when combined with BMB, it provided independent prognostic value for both PFS and OS (p = 0.026 and p = 0.033, respectively). Based on these findings, we propose a prognostic model (MCL-PET-I) that incorporates BMI by PET/CT, allowing for the identification of three groups with distinct clinical outcomes (p < 0.0001 for PFS and p = 0.00025 for OS). Conclusions: In the upfront work of MCL, PET/CT-based BMI has greater prognostic impact, while BMB remains essential for staging. We propose the MCL-PET-I prognostic index, which effectively differentiates between clinical risk groups. Keywords: mantle cell lymphoma; PET/CT; bone marrow biopsy Author: Isabel Ródenas Quiñonero, Javier Marco-Ayala, Tzu-Hua Chen-Liang, Fátima de la Cruz-Vicente, Tycho Baumann, José-Tomás Navarro, Alejandro Martín García-Sancho, Taida Martin-Santos, Javier López-Jiménez, Rafael Andreu, Ester Parra, Andrea Usas, David Alonso, Marta Fernández-González, Pablo Palomo Rumschisky, Laura Frutos, José Luis Navarro, Rosa María Alvarez-Perez, Pilar Sarandeses, Montserrat Cortes, Pilar Tamayo, Jon Uña, Alberto Martínez-Lorca, Cristina Ruiz, María Luisa Lozano and Francisco José Ortuño Creator: LaTeX with hyperref Producer: pdfTeX-1.40.25 CreationDate: Wed Dec 18 05:59:45 2024 CET ModDate: Wed Dec 18 06:03:29 2024 CET Custom Metadata: no Metadata Stream: no Tagged: no UserProperties: no Suspects: no Form: none JavaScript: no Pages: 14 Encrypted: no Page size: 595.276 x 841.89 pts (A4) Page rot: 0 File size: 664261 bytes Optimized: no PDF version: 1.7 name type encoding emb sub uni object ID ------------------------------------ ----------------- ---------------- --- --- --- --------- JYPLJJ+VnURWPalladioL-Bold Type 1 Custom yes yes yes 10 0 QHPHKL+URWPalladioL-Bold Type 1 Custom yes yes yes 16 0 KMOAVB+URWPalladioL-Roma Type 1 Custom yes yes yes 22 0 UHYVGG+URWPalladioL-Ital Type 1 Custom yes yes yes 27 0 FFGMKQ+VnURWPalladioL Type 1 Custom yes yes yes 32 0 PDTLUH+CMSY10 Type 1 Builtin yes yes yes 65 0 LWLIVD+EURM10 Type 1 Builtin yes yes yes 73 0 QSECBH+URWPalladioL-BoldItal Type 1 Custom yes yes yes 78 0 JFOFPI+PalatinoLinotype,Bold TrueType WinAnsi yes yes no 102 0 JFOFPJ+PalatinoLinotype CID TrueType Identity-H yes yes yes 105 0 JFOFPK+PalatinoLinotype TrueType WinAnsi yes yes no 111 0 JFOFPM+PalatinoLinotype,Italic TrueType WinAnsi yes yes no 114 0 JFOGFN+PalatinoLinotype TrueType MacRoman yes yes no 117 0 JBTTSN+VnURWPalladioL-Italic Type 1 Custom yes yes yes 134 0 Jhove (Rel. 1.28.0, 2023-05-18) Date: 2025-06-06 02:13:05 CEST RepresentationInformation: cancers-16-04189.pdf ReportingModule: PDF-hul, Rel. 1.12.4 (2023-03-16) LastModified: 2025-06-05 16:31:43 CEST Size: 664261 Format: PDF Version: 1.7 Status: Well-Formed and valid SignatureMatches: PDF-hul MIMEtype: application/pdf PDFMetadata: Objects: 340 FreeObjects: 1 IncrementalUpdates: 0 DocumentCatalog: PageLayout: SinglePage PageMode: UseNone Outlines: Item: Title: Introduction Destination: section.1 Item: Title: Patients and Methods Destination: section.2 Children: Item: Title: Our Study Is a Retrospective Analysis with Consecutive Recruitment of Patients with the Following Characteristics Destination: subsection.2.1 Children: Item: Title: Patients Destination: subsubsection.2.1.1 Item: Title: Bone Marrow Biopsy Destination: subsubsection.2.1.2 Item: Title: PET/CT Imaging and Analysis Destination: subsubsection.2.1.3 Item: Title: Statistics Destination: subsubsection.2.1.4 Item: Title: Results Destination: section.3 Children: Item: Title: Patient Characteristics Destination: subsection.3.1 Item: Title: Performance of PET/CT and BMB Findings in Staging Destination: subsection.3.2 Item: Title: Impact of PET-CT and BMB Findings on Survival Destination: subsection.3.3 Children: Item: Title: Whole Cohort: Deconstructed Prognostic Scores Destination: subsubsection.3.3.1 Item: Title: Intensively Treated MCL Cohort: Deconstructed Prognostic Scores Destination: subsubsection.3.3.2 Item: Title: PFS Prognostic Model Score Calculation-Mantle Cell Lymphoma PET/CT Index (MCL-PET-I) Destination: subsection.3.4 Item: Title: Discussion Destination: section.4 Item: Title: Conclusions Destination: section.5 Item: Title: References Destination: section.6 Info: Title: The Value of Bone Marrow Assessment by FDG PET/CT, Biopsy and Aspirate in the Upfront Evaluation of Mantle Cell Lymphoma: A Nationwide Cohort Study Author: Isabel Ródenas Quiñonero, Javier Marco-Ayala, Tzu-Hua Chen-Liang, Fátima de la Cruz-Vicente, Tycho Baumann, José-Tomás Navarro, Alejandro Martín García-Sancho, Taida Martin-Santos, Javier López-Jiménez, Rafael Andreu, Ester Parra, Andrea Usas, David Alonso, Marta Fernández-González, Pablo Palomo Rumschisky, Laura Frutos, José Luis Navarro, Rosa María Alvarez-Perez, Pilar Sarandeses, Montserrat Cortes, Pilar Tamayo, Jon Uña, Alberto Martínez-Lorca, Cristina Ruiz, María Luisa Lozano and Francisco José Ortuño Subject: Background: Assessment of bone marrow infiltration (BMI) is part of the initial staging of mantle cell lymphoma (MCL), although BMI evaluated by biopsy (BMB) is not considered significant in the MIPI scales, and standardized recommendations remain lacking. Objectives: To evaluate the accuracy and prognostic impact of BMI assessed by PET/CT and BMB in a large series of MCL patients. Methods: We deconstructed the IPI-NCCN, MIPI, and MIPI-c indices and considered BMI as positive if indicated by a BMB, PET/CT scan, or a combination of both. Results: In the total cohort (n = 148), 110 patients had BMI detected by BMB and 33 by PET/CT. The sensitivity of BMB was higher than that of PET/CT (94.8% vs. 28.4%), as were its negative predictive value (84.2% vs. 27.8%) and accuracy (95.9% vs. 43.9%). In the total cohort, BMI detected by PET/CT showed a significant predictive value for PFS (p = 0.027), while BMB demonstrated independent prognostic value only in combination with PET/CT (p = 0.025). Among intensively treated patients (n = 128), PET/CT had significant clinical impact on PFS (p = 0.030), and when combined with BMB, it provided independent prognostic value for both PFS and OS (p = 0.026 and p = 0.033, respectively). Based on these findings, we propose a prognostic model (MCL-PET-I) that incorporates BMI by PET/CT, allowing for the identification of three groups with distinct clinical outcomes (p < 0.0001 for PFS and p = 0.00025 for OS). Conclusions: In the upfront work of MCL, PET/CT-based BMI has greater prognostic impact, while BMB remains essential for staging. We propose the MCL-PET-I prognostic index, which effectively differentiates between clinical risk groups. 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