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September 27, 2017Cancer MedicineOpen Access

Bone marrow biopsy superiority over PET/CT in predicting progression‐free survival in a homogeneously‐treated cohort of diffuse large B‐cell lymphoma

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Key result

Bone marrow involvement detected by bone marrow biopsy (HR 3.6), but not by PET/CT, independently predicted shorter progression-free survival in DLBCL patients treated with first-line R-CHOP/21.

Why the study?

Does bone marrow biopsy compared to PET/CT better predict progression-free survival in patients with diffuse large B-cell lymphoma?

Population

268 patients with diffuse large B-cell lymphoma with a bone marrow biopsy and a PET/CT available at…

Comparison

Bone marrow biopsy (BMB) for staging and prognosis vs PET/CT for staging and prognosis

Design

Cohort

Follow-up

median 25 months

Authors

TCTzu Hua Chen‐LiangTMTaida Martín‐SantosAJAndrés Jerez

Discussion

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Member takes

Overview

BMB positivity may flag higher-risk DLBCL missed by PET/CT; leaves open whether routine BMB refines staging beyond imaging alone.

Study Design

Type

Cohort (n=268)

Multicenter

Yes

Structured PICO

Does bone marrow biopsy compared to PET/CT better predict progression-free survival in patients with diffuse large B-cell lymphoma?

P
Population
268 patients with diffuse large B-cell lymphoma who had bone marrow biopsy and PET/CT at diagnosis, with survival analysis on 203 patients treated with first-line R-CHOP/21 followed for a median of 25 months.
E
Exposure
Bone marrow biopsy (BMB) for staging and prognosis
C
Comparator
PET/CT for staging and prognosis
O
Outcome
Progression-free survival (PFS) and overall survival (OS)hard clinical

Main Result

Hazard Ratio: 3.6

Bone marrow biopsy is superior to PET/CT in predicting progression-free survival in DLBCL patients treated with uniform first-line chemotherapy.

Cite This Study

Chen‐Liang et al. (2017) conducted a cohort in Diffuse large B-cell lymphoma (DLBCL) (n=268). Bone marrow involvement by bone marrow biopsy vs. Bone marrow involvement by PET/CT was evaluated on Progression-free survival (PFS) (HR 3.6). Bone marrow involvement detected by bone marrow biopsy (HR 3.6), but not by PET/CT, independently predicted shorter progression-free survival in DLBCL patients treated with first-line R-CHOP/21.

synapsesocial.com/papers/6a7b1ef714b028facf0eb0f6https://doi.org/10.1002/cam4.1205
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Also Consider

Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context:

  1. 1An enhanced International Prognostic Index (NCCN-IPI) for patients with diffuse large B-cell lymphoma treated in the rituximab era2013 · 967 citations
  2. 2Recommendations for Initial Evaluation, Staging, and Response Assessment of Hodgkin and Non-Hodgkin Lymphoma: The Lugano Classification2014 · 5,731 citations
  3. 3Increased bone marrow <scp>FDG</scp> uptake at <scp>PET</scp>/<scp>CT</scp> is not a sufficient proof of bone marrow involvement in diffuse large <scp>B</scp>‐cell lymphoma2015 · 14 citations
  4. 4Bone marrow <sup>18</sup>F‐fluoro‐2‐deoxy‐<scp>d</scp>‐glucose positron emission tomography/computed tomography cannot replace bone marrow biopsy in diffuse large B‐cell lymphoma2014 · 77 citations
  5. 5Combined PET and Biopsy Evidence of Marrow Involvement Improves Prognostic Prediction in Diffuse Large B-Cell Lymphoma2014 · 76 citations