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
Ródenas-Quiñonero, Isabel (Hospital General Universitario Morales Meseguer (Múrcia))
Marco-Ayala, Javier (Hospital General Universitario Morales Meseguer (Múrcia))
Chen-Liang, Tzu (Hospital General Universitario Morales Meseguer (Múrcia))
de la Cruz-Vicente, Fátima (Hospital Universitario Virgen del Rocío (Sevilla, Andalusia))
Baumann, Tycho (Hospital Universitario 12 de Octubre (Madrid))
Navarro Ferrando, José Tomás (Institut Germans Trias i Pujol. Institut de Recerca contra la Leucèmia Josep Carreras)
Martín García-Sancho, Alejandro (Hospital Universitario de Salamanca)
Martin-Santos, Taida (Hospital Universitario de Canarias (La Laguna))
Lopez-Jimenez, Javier (Hospital Universitario Ramón y Cajal (Madrid))
Andreu, Rafael (Hospital Universitari i Politècnic La Fe (València))
Parra, Ester (Hospital Universitario 12 de Octubre (Madrid))
Usas, Andrea (Institut Germans Trias i Pujol. Institut de Recerca contra la Leucèmia Josep Carreras)
Alonso, David (Hospital Universitario de Salamanca)
Fernández-González, Marta (Hospital Universitario de Canarias (La Laguna))
Palomo Rumschisky, Pablo (Hospital Universitario Ramón y Cajal (Madrid))
Frutos, Laura (Hospital Universitario Virgen de la Arrixaca (Múrcia))
Navarro, Jose Luis (Hospital Universitario Virgen de la Arrixaca (Múrcia))
Alvarez-Perez, Rosa Maria (Hospital Universitario Virgen del Rocío (Sevilla, Andalusia))
Sarandeses Fernandez, Pilar (Hospital Universitario 12 de Octubre (Madrid))
Cortés, Montserrat (Hospital Universitari de Bellvitge)
Tamayo Alonso, M. Pilar (Hospital Clínico Universitario (Salamanca))
Uña-Gorospe, Jon Andoni (Hospital Universitario de Canarias (La Laguna))
Martínez-Lorca, Alberto (Hospital Universitario Ramón y Cajal (Madrid))
Ruiz, Cristina (Hospital Universitari i Politècnic La Fe (València))
Lozano, María Luisa (Universidad de Murcia)
Ortuño, Francisco José (Hospital General Universitario Morales Meseguer (Múrcia))

Date:	2024
Abstract:	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.
Rights:	Aquest document està subjecte a una llicència d'ús Creative Commons. Es permet la reproducció total o parcial, la distribució, la comunicació pública de l'obra i la creació d'obres derivades, fins i tot amb finalitats comercials, sempre i quan es reconegui l'autoria de l'obra original.
Language:	Anglès
Document:	Article ; recerca ; Versió publicada
Subject:	Mantle cell lymphoma ; PET/CT ; Bone marrow biopsy
Published in:	Cancers, Vol. 16 Núm. 24 (December 2024) , ISSN 2072-6694

DOI: 10.3390/cancers16244189
PMID: 39766089

14 p, 648.7 KB

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Research literature > UAB research groups literature > Research Centres and Groups (research output) > Health sciences and biosciences > Institut d'Investigació en Ciencies de la Salut Germans Trias i Pujol (IGTP) > Josep Carreras Leukaemia Research Institute
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Articles > Published articles