[¹⁸F]FDG-PET/CT volumetric parameters can predict outcome in untreated mantle cell lymphoma

Abstract

Several studies have shown a strong predictive value for pretreatment [¹⁸F]FDG-PET/CT metabolic parameters in different lymphoma subtypes. However, few publications exist concerning the role of metabolic parameters in mantle cell lymphoma (MCL). We retrospectively investigated the prognostic value of baseline metabolic tumor volume (MTV) and lesion dissemination in untreated MCL. We compared it to currently used prognostic factors such as stage, mantle cell lymphoma international prognostic index (MIPI) and KI-67. We report that a higher baseline MTV is a risk factor for worse overall survival (OS), progression-free survival (PFS), and disease-specific survival (DSS) in univariate analysis. In multivariate analysis, MTV was significantly associated with DSS, but not with OS and PFS. We found no correlation between lesion dissemination and outcome. The MIPI score remains the strongest predictor of outcome. These results show that MTV is an important prognostic tool and can improve patient risk stratification at staging of untreated MCL.

Keywords:

• Mantle cell lymphoma
• [¹⁸F]FDG-PET/CT
• metabolic tumor volume
• lesion dissemination
• prognosis

Acknowledgements

We would like to thank Wies Deckers for technical support and Annoushka Laenen for statistical analysis.

Ethical approval

The study has been approved by the Ethics Committee of University Hospitals/KU Leuven (ref: S65186), and for all subjects the need for written informed consent was waived. This study was conducted according to the ethical principles of the World Medical Association Declaration of Helsinki.

Author contributions

VV, CMD, and DD participated in concept and design and drafting of the article. VV, CMD, and AL participated in data extraction and analysis. VV, CMD, GV, AJ, FJSW, AL, TT, and DD participated in critical revision of the article for intellectually important content. All authors read and approved the final manuscript.

Disclosure statement

VV reports consultancy fees from Beigene, BMS/Cellgene, Gilead/Kite, speaker fees from Janssen, travel support from Amgen, Abbvie, Gilead/Kite; all paid to her institution. AJ reports consultancy fees from Astra Zeneca, Janssen, Novartis, Sanofi, Sobi, Sandoz, MSD, Incyte, and Beigene. TT reports consultancy and speaker fees from EUSApharma; all paid to his institution. D.D. reports grants/research support from Roche; personal fees/honoraria from Takeda, Novartis, Amgen, Atara Biotherapeutics, and Incyte; all paid to his institution. CMD reports consultancy fees from Sirtex, PSI CRO, Terumo, and Ipsen and speaker fees from Ipsen; all paid to his institution. The other authors declare no conflict of interest regarding current work.

Data availability statement

The data that support the findings of this study are available from the corresponding author upon reasonable request. The data are not publicly available due to privacy or ethical restrictions.

Additional information

Funding

DD holds a mandate for Clinical and Translational Research from ‘Kom op tegen Kanker’ (2017/10908/2816). TT holds a Mandate for Fundamental and Translational Research from the ‘Stichting tegen Kanker’ (2019-091) and is a co-founder of the Fund ‘Me To You’ supporting research in lymphoma/leukemia. CMD is a Senior Clinical Investigator from the Research Foundation—Flanders (FWO).