Interim FDG-PET/CT as a predictor of prognosis for HIV-related malignant lymphoma: Preliminary study

Abstract

Object: The aim of this retrospective study was to clarify the potential of fluorodeoxyglucose-positron emission tomography/computed tomography (FDG-PET/CT) for predicting prognosis in HIV-related malignant lymphoma (ML).

Methods: Participants comprised 24 patients (23 men, 1 woman; mean age, 42.2 years; range, 25-66 years) with histologically proven ML, classified as either diffuse large B-cell lymphoma (DLBCL) or Burkitt lymphoma according to the classification of the World Health Organization. We compared relationships between overall survival (OS) and several indices, including FDG uptake into the lesion site on pretreatment PET and findings on interim PET. Diagnostic criteria for response evaluation followed International Harmonization Project criteria.

Results: Negative findings on interim PET were associated with significantly longer OS (932±549 days) compared to positive cases (454±442 days, p=0.043). Cox regression analysis showed strong prognostic influences of interim PET findings (Hazard ratio 4.57, 95%CI 0.88-23.73) and Eastern Cooperative Oncology Group performance status (Hazard ratio 10.52, 95%CI 1.26-87.82) on OS. No other indices showed significant relationships with OS. No significant correlation was confirmed between OS and both age and lesion uptake of FDG on pretreatment PET.

Conclusion: HIV-related ML patients with negative findings on interim FDG-PET showed longer OS than patients with positive findings. Interim FDG-PET offers a predictor of prognosis for HIV-related ML.