Baseline total metabolic tumor volume is prognostic for refractoriness to Iimunochemotherapy in DLBCL: results from GOYA

Introduction A good response to initial therapy is key to maximizing survival in patients with diffuse large B-cell lymphoma (DLBCL), but patients with chemorefractory disease and early progression have poor outcomes. Patients and Methods Data from the GOYA study in patients with DLBCL who received...

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Autores: Canales-Ruiz, I. (Irene)|||/items/a90dde96-9ef9-4994-8840-851258793345, Martelli, M. (Mauricio)|||/items/a6d679d0-6c63-4e20-8236-e3483db90b03, Sehn, L.H. (Laura H.)|||/items/8c73dec6-a8b0-48d9-bdfe-c29f6c78affb, Vitolo, U. (Umberto)|||/items/8335cc7b-e868-44e3-8c75-27c5f7f78d18, Nielsen, T.G. (Tina G.)|||/items/4cca2474-652c-41e4-8725-0f55b404d1f9, Sellam, G. (Gilla)|||/items/2c37a1d4-1e88-44c7-aa6f-87899e3775ff, Bottos, A. (Alessia)|||/items/7afca8ed-325b-4868-a036-15c75e312526, Klingbiel, D. (Dirk)|||/items/b0e08286-dfa8-454a-b04d-3fc01634368a, Kostakoglu, L. (Lale)|||/items/81de2cb9-9f5a-4251-8999-5c269eba5523
Tipo de recurso: artículo
Fecha de publicación:2022
País:España
Institución:Universidad de Navarra
Repositorio:Dadun. Depósito Académico Digital de la Universidad de Navarra
Idioma:inglés
OAI Identifier:oai:dadun.unav.edu:10171/66123
Acceso en línea:https://hdl.handle.net/10171/66123
Access Level:acceso abierto
Palabra clave:Lymphoid malignancies
Primary chemorefractory disease
Prognostic indicators
Early relapse
Overall survival
Unidad de Investigación clínica
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spelling Baseline total metabolic tumor volume is prognostic for refractoriness to Iimunochemotherapy in DLBCL: results from GOYACanales-Ruiz, I. (Irene)|||/items/a90dde96-9ef9-4994-8840-851258793345Martelli, M. (Mauricio)|||/items/a6d679d0-6c63-4e20-8236-e3483db90b03Sehn, L.H. (Laura H.)|||/items/8c73dec6-a8b0-48d9-bdfe-c29f6c78affbVitolo, U. (Umberto)|||/items/8335cc7b-e868-44e3-8c75-27c5f7f78d18Nielsen, T.G. (Tina G.)|||/items/4cca2474-652c-41e4-8725-0f55b404d1f9Sellam, G. (Gilla)|||/items/2c37a1d4-1e88-44c7-aa6f-87899e3775ffBottos, A. (Alessia)|||/items/7afca8ed-325b-4868-a036-15c75e312526Klingbiel, D. (Dirk)|||/items/b0e08286-dfa8-454a-b04d-3fc01634368aKostakoglu, L. (Lale)|||/items/81de2cb9-9f5a-4251-8999-5c269eba5523Lymphoid malignanciesPrimary chemorefractory diseasePrognostic indicatorsEarly relapseOverall survivalUnidad de Investigación clínicaIntroduction A good response to initial therapy is key to maximizing survival in patients with diffuse large B-cell lymphoma (DLBCL), but patients with chemorefractory disease and early progression have poor outcomes. Patients and Methods Data from the GOYA study in patients with DLBCL who received first-line rituximab or obinutuzumab plus cyclophosphamide, doxorubicin, vincristine, and prednisone (CHOP) were analyzed. Positron emission tomography/computed tomography (PET/CT)-derived characteristics associated with total metabolic tumor volume (TMTV) and clinical risk factors for primary chemorefractory disease and disease progression within 12 months (POD12) were explored. Results Of those patients fulfilling the criteria for analysis, 108/1126 (10%) were primary chemorefractory and 147/1106 (13%) had POD12. Primary chemorefractory and POD12 status were strongly associated with reduced overall survival. After multivariable analysis of clinical and imaging-based risk factors by backward elimination, only very high TMTV (quartile [Q] 1 vs. Q4 odds ratio [OR]: 0.45; P = .006) and serum albumin levels (low vs. normal OR of 1.86; P = .004) were associated with primary chemorefractoriness. After additionally accounting for BCL2/MYC translocation in a subset of patients, TMTV and BCL2/MYC double-hit status remained as significant predictors of primary chemorefractoriness (Q1 vs. Q4 OR: 0.32, P = .01 and double-hit vs. no-hit OR of 4.47, P = .02, respectively). Risk factors including very high TMTV, high sum of the product of the longest diameters (SPD), geographic region (Asia), short time since diagnosis, extranodal involvement and low serum albumin were retained for POD12. Conclusion PET-derived TMTV has prognostic value in identifying patients at risk of early treatment failure.Dadun. Depósito Académico Digital Universidad de Navarra20232023-04-2720222022-01-0120222022-01-01journal articlehttp://purl.org/coar/resource_type/c_6501info:eu-repo/semantics/articleapplication/pdfhttps://hdl.handle.net/10171/66123reponame:Dadun. Depósito Académico Digital de la Universidad de Navarrainstname:Universidad de NavarraInglésengopen accesshttp://purl.org/coar/access_right/c_abf2info:eu-repo/semantics/openAccessoai:dadun.unav.edu:10171/661232026-06-21T12:47:57Z
dc.title.none.fl_str_mv Baseline total metabolic tumor volume is prognostic for refractoriness to Iimunochemotherapy in DLBCL: results from GOYA
title Baseline total metabolic tumor volume is prognostic for refractoriness to Iimunochemotherapy in DLBCL: results from GOYA
spellingShingle Baseline total metabolic tumor volume is prognostic for refractoriness to Iimunochemotherapy in DLBCL: results from GOYA
Canales-Ruiz, I. (Irene)|||/items/a90dde96-9ef9-4994-8840-851258793345
Lymphoid malignancies
Primary chemorefractory disease
Prognostic indicators
Early relapse
Overall survival
Unidad de Investigación clínica
title_short Baseline total metabolic tumor volume is prognostic for refractoriness to Iimunochemotherapy in DLBCL: results from GOYA
title_full Baseline total metabolic tumor volume is prognostic for refractoriness to Iimunochemotherapy in DLBCL: results from GOYA
title_fullStr Baseline total metabolic tumor volume is prognostic for refractoriness to Iimunochemotherapy in DLBCL: results from GOYA
title_full_unstemmed Baseline total metabolic tumor volume is prognostic for refractoriness to Iimunochemotherapy in DLBCL: results from GOYA
title_sort Baseline total metabolic tumor volume is prognostic for refractoriness to Iimunochemotherapy in DLBCL: results from GOYA
dc.creator.none.fl_str_mv Canales-Ruiz, I. (Irene)|||/items/a90dde96-9ef9-4994-8840-851258793345
Martelli, M. (Mauricio)|||/items/a6d679d0-6c63-4e20-8236-e3483db90b03
Sehn, L.H. (Laura H.)|||/items/8c73dec6-a8b0-48d9-bdfe-c29f6c78affb
Vitolo, U. (Umberto)|||/items/8335cc7b-e868-44e3-8c75-27c5f7f78d18
Nielsen, T.G. (Tina G.)|||/items/4cca2474-652c-41e4-8725-0f55b404d1f9
Sellam, G. (Gilla)|||/items/2c37a1d4-1e88-44c7-aa6f-87899e3775ff
Bottos, A. (Alessia)|||/items/7afca8ed-325b-4868-a036-15c75e312526
Klingbiel, D. (Dirk)|||/items/b0e08286-dfa8-454a-b04d-3fc01634368a
Kostakoglu, L. (Lale)|||/items/81de2cb9-9f5a-4251-8999-5c269eba5523
author Canales-Ruiz, I. (Irene)|||/items/a90dde96-9ef9-4994-8840-851258793345
author_facet Canales-Ruiz, I. (Irene)|||/items/a90dde96-9ef9-4994-8840-851258793345
Martelli, M. (Mauricio)|||/items/a6d679d0-6c63-4e20-8236-e3483db90b03
Sehn, L.H. (Laura H.)|||/items/8c73dec6-a8b0-48d9-bdfe-c29f6c78affb
Vitolo, U. (Umberto)|||/items/8335cc7b-e868-44e3-8c75-27c5f7f78d18
Nielsen, T.G. (Tina G.)|||/items/4cca2474-652c-41e4-8725-0f55b404d1f9
Sellam, G. (Gilla)|||/items/2c37a1d4-1e88-44c7-aa6f-87899e3775ff
Bottos, A. (Alessia)|||/items/7afca8ed-325b-4868-a036-15c75e312526
Klingbiel, D. (Dirk)|||/items/b0e08286-dfa8-454a-b04d-3fc01634368a
Kostakoglu, L. (Lale)|||/items/81de2cb9-9f5a-4251-8999-5c269eba5523
author_role author
author2 Martelli, M. (Mauricio)|||/items/a6d679d0-6c63-4e20-8236-e3483db90b03
Sehn, L.H. (Laura H.)|||/items/8c73dec6-a8b0-48d9-bdfe-c29f6c78affb
Vitolo, U. (Umberto)|||/items/8335cc7b-e868-44e3-8c75-27c5f7f78d18
Nielsen, T.G. (Tina G.)|||/items/4cca2474-652c-41e4-8725-0f55b404d1f9
Sellam, G. (Gilla)|||/items/2c37a1d4-1e88-44c7-aa6f-87899e3775ff
Bottos, A. (Alessia)|||/items/7afca8ed-325b-4868-a036-15c75e312526
Klingbiel, D. (Dirk)|||/items/b0e08286-dfa8-454a-b04d-3fc01634368a
Kostakoglu, L. (Lale)|||/items/81de2cb9-9f5a-4251-8999-5c269eba5523
author2_role author
author
author
author
author
author
author
author
dc.contributor.none.fl_str_mv Dadun. Depósito Académico Digital Universidad de Navarra
dc.subject.none.fl_str_mv Lymphoid malignancies
Primary chemorefractory disease
Prognostic indicators
Early relapse
Overall survival
Unidad de Investigación clínica
topic Lymphoid malignancies
Primary chemorefractory disease
Prognostic indicators
Early relapse
Overall survival
Unidad de Investigación clínica
description Introduction A good response to initial therapy is key to maximizing survival in patients with diffuse large B-cell lymphoma (DLBCL), but patients with chemorefractory disease and early progression have poor outcomes. Patients and Methods Data from the GOYA study in patients with DLBCL who received first-line rituximab or obinutuzumab plus cyclophosphamide, doxorubicin, vincristine, and prednisone (CHOP) were analyzed. Positron emission tomography/computed tomography (PET/CT)-derived characteristics associated with total metabolic tumor volume (TMTV) and clinical risk factors for primary chemorefractory disease and disease progression within 12 months (POD12) were explored. Results Of those patients fulfilling the criteria for analysis, 108/1126 (10%) were primary chemorefractory and 147/1106 (13%) had POD12. Primary chemorefractory and POD12 status were strongly associated with reduced overall survival. After multivariable analysis of clinical and imaging-based risk factors by backward elimination, only very high TMTV (quartile [Q] 1 vs. Q4 odds ratio [OR]: 0.45; P = .006) and serum albumin levels (low vs. normal OR of 1.86; P = .004) were associated with primary chemorefractoriness. After additionally accounting for BCL2/MYC translocation in a subset of patients, TMTV and BCL2/MYC double-hit status remained as significant predictors of primary chemorefractoriness (Q1 vs. Q4 OR: 0.32, P = .01 and double-hit vs. no-hit OR of 4.47, P = .02, respectively). Risk factors including very high TMTV, high sum of the product of the longest diameters (SPD), geographic region (Asia), short time since diagnosis, extranodal involvement and low serum albumin were retained for POD12. Conclusion PET-derived TMTV has prognostic value in identifying patients at risk of early treatment failure.
publishDate 2022
dc.date.none.fl_str_mv 2022
2022-01-01
2022
2022-01-01
2023
2023-04-27
dc.type.none.fl_str_mv journal article
http://purl.org/coar/resource_type/c_6501
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format article
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url https://hdl.handle.net/10171/66123
dc.language.none.fl_str_mv Inglés
eng
language_invalid_str_mv Inglés
language eng
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dc.rights.openaire.fl_str_mv info:eu-repo/semantics/openAccess
rights_invalid_str_mv open access
http://purl.org/coar/access_right/c_abf2
eu_rights_str_mv openAccess
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instname:Universidad de Navarra
instname_str Universidad de Navarra
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