RESUMO
BACKGROUND: [18F]fluorodeoxyglucose-positron emission tomography (PET) is emerging as a strong diagnostic and prognostic tool in follicular lymphoma (FL) patients. PATIENTS AND METHODS: In a subset analysis of the FOLL05 trial (NCT00774826), we investigated the prognostic role of post-induction PET (PI-PET) scan. Patients were eligible to this study if they had a PI-PET scan carried out within 3 months from the end of induction immunochemotherapy. Progression-free survival (PFS) was the primary study end point. RESULTS: A total of 202 patients were eligible and analysed for this study. The median age was 55 years (range 33-75). Overall, PI-PET was defined as positive in 49 (24%) patients. Conventional response assessment with CT scan was substantially modified by PET: 15% (22/145) of patients considered as having a complete response (CR) after CT were considered as having partial response (PR) after PI-PET and 53% (30/57) patients considered as having a PR after CT were considered as a CR after PI-PET. With a median follow-up of 34 months, the 3-year PFS was 66% and 35%, respectively, for patients with negative and positive PI-PET (P<0.001). At multivariate analysis, PI-PET (hazard ratio 2.57, 95% confidence interval 1.52-4.34, P<0.001) was independent of conventional response, FLIPI and treatment arm. Also, the prognostic role of PI-PET was maintained within each FLIPI risk group. CONCLUSIONS: In FL patients, PI-PET substantially modifies response assessment and is strongly predictive for the risk of progression. PET should be considered in further updates of response criteria.
Assuntos
Protocolos de Quimioterapia Combinada Antineoplásica/uso terapêutico , Fluordesoxiglucose F18 , Linfoma Folicular/diagnóstico por imagem , Compostos Radiofarmacêuticos , Intervalo Livre de Doença , Feminino , Humanos , Quimioterapia de Indução , Estimativa de Kaplan-Meier , Linfoma Folicular/tratamento farmacológico , Linfoma Folicular/mortalidade , Masculino , Pessoa de Meia-Idade , Análise Multivariada , Tomografia por Emissão de Pósitrons , Prognóstico , Modelos de Riscos Proporcionais , Estudos Retrospectivos , Resultado do TratamentoRESUMO
42 patients (33 males and 9 females) with chromic active hepatitis (CAH) mostly HBsAg+, were typed for 24 alleles of the A and B loci. Diagnosis was performed according to the criteria outlined by the European Association for the Study of the Liver. The increased frequency of HLA-A3 (47.6% instead of 19.1% in 266 healthy controls) is significant after correction. The relative risk is 3.83. The phenotypic association A3/Bw35 is also increased (28.5% instead of 6.0 in the control group). The risk of the A3/Bw35 association is 6.25. The risk of A3 calculated in patients lacking Bw35 is 1.6. A family study in 5 patients over 5 showed an haplotype A3/Bw35.