The value of 18F-FDG PET/CT after autologous stem cell transplantation (ASCT) in patients affected by multiple myeloma (MM): Experience with 77 patients

Cristina Nanni, Elena Zamagni, Monica Celli, Paola Caroli, Valentina Ambrosini, Paola Tacchetti, Annamaria Brioli, Beatrice Zannetti, Annalisa Pezzi, Lucia Pantani, Giulia Perrone, Maurizio Zompatori, Michele Cavo, Patrick M. Colletti, Domenico Rubello, Stefano Fanti

Research output: Contribution to journalArticlepeer-review

Abstract

AIM: The objective of this study was to analyze the prognostic value of F-FDG PET/CT after therapy in patients with multiple myeloma (MM). PATIENTS AND METHODS: One hundred seven patients prospectively recruited with MM had FDG PET/CT at staging 3 months after therapy (autologous stem cell transplantation) and every 6 to 12 months during the follow-up (mean 41 months). Patients were divided into group 1 (relapsed) and group 2 (nonrelapsed). In group 1, PET results and SUVmax were compared to the time to relapse (TTR). In group 2, the presence of PET finding changes during follow-up was analyzed to identify typical patterns of disease behavior (ie, late responders or stabilized disease). Patients with a negative PET at staging were excluded from further evaluation. RESULTS: Forty-seven out of 107 (44%) patients relapsed: 10 were excluded because of a negative PET at staging. In group 1, 22 patients had a negative posttherapy PET (59%, mean TTR = 27.6 months) and 15 had a positive posttherapy PET (41%, mean TTR = 18 months). There was a significant difference between the TTR of the two subgroups (t test P = 0.05). In patients with a positive posttherapy PET, the SUVmax was inversely correlated to the TTR (correlation coefficient = -0.7; P <0.01).Sixty out of 107 (56%) patients did not relapse. Twenty patients were excluded because of a negative PET at staging. In group 2, 27 patients had a negative posttherapy PET (68%) and 13 had a positive posttherapy PET (32%). None of nonrelapsed patients showed a progressive increase in SUVmax during the follow-up. There was no significant difference between relapsed and nonrelapsed patients in terms of SUVmax at posttherapy PET/CT (t test P = 0.7). CONCLUSION: In our series of MM patients, a negative posttherapy PET was predictive for nonrelapse or a long disease-free survival. In contrast, a persistent significantly increased SUVmax after therapy was correlated to a short TTR.

Original languageEnglish
JournalClinical Nuclear Medicine
Volume38
Issue number2
DOIs
Publication statusPublished - Feb 2013

Keywords

  • autotransplantation
  • FDG PET/CT
  • multiple myeloma
  • prognosis

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging

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