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Article

Prognostic Significance of PET/CT in Patients with Chronic Lymphocytic Leukemia (CLL) Treated with Frontline Chemoimmunotherapy

1
Hematology, Department of Translational and Precision Medicine, Sapienza University, Via Benevento 6, 00161 Rome, Italy
2
Institute of Diagnostic and Nuclear Research, IRCCS SDN, 80143 Naples, Italy
3
Department of Molecular Medicine, “Sapienza” University of Rome, 00161 Roma, Italy
4
Division of Hematology, A.O.U. Città della Salute e della Scienza di Torino and Department of Molecular Biotechnology and Health Sciences, University of Turin, 10124 Torino, Italy
5
Division of Hematology, Department of Translational Medicine, University of Eastern Piedmont, 28100 Novara, Italy
6
UOSD Hematology, ASL Roma 1, 00193 Rome, Italy
7
Department of Psychology, Catholic University of the Sacred-Heart, 20123 Milan, Italy
8
Department of Surgical Sciences, Sapienza University, 00161 Rome, Italy
*
Author to whom correspondence should be addressed.
Cancers 2020, 12(7), 1773; https://doi.org/10.3390/cancers12071773
Received: 21 May 2020 / Revised: 26 June 2020 / Accepted: 1 July 2020 / Published: 3 July 2020
(This article belongs to the Special Issue Chronic Lymphocytic Leukemia)
The role of positron emission tomography/computed tomography (PET/CT) in identifying Richter Syndrome (RS) is well established, while its impact on the survival of patients with chronic lymphocytic leukemia (CLL) has been less explored. The clinical characteristics and PET/CT data of 40 patients with a biopsy-proven CLL who required frontline chemoimmunotherapy, FCR (fludarabine, cyclophosphamide, rituximab) in 20 patients, BR (bendamustine, rituximab) in 20, were retrospectively analyzed. Standardized uptake volume (SUVmax) values ≥ 5 were observed more frequently in patients with deletion 11q (p = 0.006) and biopsies characterized by a rate of Ki67 positive cells ≥ 30% (p = 0.02). In the multivariate analysis, the presence of large and confluent PCs emerged as the only factor with a negative impact on progression-free survival (PFS), and overall survival (OS). Deletion 11q also revealed a significant and independent effect on PFS. SUVmax values ≥ 5 showed no statistical impact on PFS while in multivariate analysis, they revealed a significant adverse impact on OS (median survival probability not reached vs. 56 months; p = 0.002). Moreover, patients with higher SUVmax values more frequently developed Richter Syndrome (p = 0.015). Our results show that higher SUVmax values identify CLL patients with a pronounced rate of proliferating cells in the lymph-node compartment, inferior survival, and an increased risk of developing RS. View Full-Text
Keywords: chronic lymphocytic leukemia; PET/CT; survival chronic lymphocytic leukemia; PET/CT; survival
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MDPI and ACS Style

Porrazzo, M.; Nicolai, E.; Riminucci, M.; Vitale, C.; Coscia, M.; De Paoli, L.; Rago, A.; Buscicchio, G.; Maestrini, G.; Ligia, S.; Di Prima, A.; Corsi, A.; Caronna, R.; Gaidano, G.; Mauro, F.R. Prognostic Significance of PET/CT in Patients with Chronic Lymphocytic Leukemia (CLL) Treated with Frontline Chemoimmunotherapy. Cancers 2020, 12, 1773. https://doi.org/10.3390/cancers12071773

AMA Style

Porrazzo M, Nicolai E, Riminucci M, Vitale C, Coscia M, De Paoli L, Rago A, Buscicchio G, Maestrini G, Ligia S, Di Prima A, Corsi A, Caronna R, Gaidano G, Mauro FR. Prognostic Significance of PET/CT in Patients with Chronic Lymphocytic Leukemia (CLL) Treated with Frontline Chemoimmunotherapy. Cancers. 2020; 12(7):1773. https://doi.org/10.3390/cancers12071773

Chicago/Turabian Style

Porrazzo, Marika; Nicolai, Emanuele; Riminucci, Mara; Vitale, Candida; Coscia, Marta; De Paoli, Lorenzo; Rago, Angela; Buscicchio, Giulia; Maestrini, Giacomo; Ligia, Silvio; Di Prima, Alessio; Corsi, Alessandro; Caronna, Roberto; Gaidano, Gianluca; Mauro, Francesca R. 2020. "Prognostic Significance of PET/CT in Patients with Chronic Lymphocytic Leukemia (CLL) Treated with Frontline Chemoimmunotherapy" Cancers 12, no. 7: 1773. https://doi.org/10.3390/cancers12071773

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