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Original Articles

Metabolic tumor volume, cancer cell fraction, and prognosis – the case of T-cell/histiocyte-rich large B-cell lymphoma

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Pages 1372-1379 | Received 30 Sep 2019, Accepted 02 Jan 2020, Published online: 05 Feb 2020
 

Abstract

T-cell/histiocyte-rich large B-cell lymphoma (THRLBCL) is a rare aggressive lymphoma characterized by a paucity of neoplastic B-cells and a majority of reactive T-cells with or without histiocytes. In the ‘Positron Emission Tomography-Guided Therapy of Aggressive Non-Hodgkin Lymphomas’ trial (clinicaltrials.gov NCT00554164; EudraCT 2006-001641-33), its frequency was less than 3%. While cancer cell content by quantitative histology was 10-times lower, baseline total metabolic tumor volume (TMTV) by 18-fluorodesoxyglucose positron emission tomography was 10-times higher in THRLBCL than in diffuse large B-cell lymphoma (DLBCL). When THRLBCL and DLBCL populations were matched for TMTV, the survival curves were superimposable. However, when the populations were matched for cancer cell volume by multiplying TMTV by cancer cell fraction, outcome in THRLBCL was worse than in DLBCL. Whether genetic differences between cancer cells, tumor-promoting properties of non-neoplastic cells, or both are responsible for inferior cancer cell volume-related outcome in THRLBCL, remains to be elucidated.

Disclosure statement

C. S.: travel reimbursement from AbbVie; S. P. M.: institutional research funding from BTG Interventional Medicine; A. H.: honoraria from Bristol-Myers Squibb, Takeda, Celgene, and Roche; travel reimbursement from Gilead and Amgen; W. K.: institutional research funding from Roche, Amgen, Regeneron, Novartis, and Takeda; U. D.: institutional research funding and honoraria from Roche and Amgen. The other authors declare no conflicts of interest.

Additional information

Funding

This work was supported by Deutsche Krebshilfe under Grant Nos. [107592 and 110515], Amgen Germany, and Roche Pharma (institutional research funding).

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