Abstract
BackgroundWe evaluated the suitability of 18F-fluorodeoxythymidine (18F-FLT) positron emission tomography (PET)/computed tomography (CT) for assessment of the early response to induction therapy and its value for predicting clinical outcome in patients with acute myeloid leukemia (AML). Adult patients who had histologically confirmed AML and received induction therapy were enrolled. All patients underwent 18F-FLT PET/CT after completion of induction. PET/CT images were visually and quantitatively assessed. Cases with intensely increased bone marrow uptake in more than one third of the long bones and throughout the central skeleton were interpreted as PET-positive for resistant disease (RD). PET results were compared to the clinical response and outcome.ResultsIn visual PET analysis of 10 eligible patients (7 male, 3 female; median age 58 years), 5 patients were interpreted as being PET-positive and 5 as PET-negative. Standardized uptake values were significantly different between PET-positive and PET-negative groups. Eight of 10 patients achieved clinical complete remission (CR)/CR with incomplete blood count recovery (CRi). Five CR/CRi patients had PET-negative findings, but 3 CR patients had PET-positive findings. Both of the RD patients had PET-positive findings. During follow-up, 2 CR patients with PET-positive findings relapsed, or were strongly suspected of relapse, 4 months after consolidation.Conclusion18F-FLT PET/CT after induction therapy showed good sensitivity and negative-predictive value for evaluating RD in patients with AML. This preliminary study suggests that 18F-FLT PET/CT may be valuable as a noninvasive tool for early assessment of the response to treatment and may provide prognostic value for survival in patients with AML.
Highlights
We evaluated the suitability of 18F-fluorodeoxythymidine (18F-FLT) positron emission tomography (PET)/ computed tomography (CT) for assessment of the early response to induction therapy and its value for predicting clinical outcome in patients with acute myeloid leukemia (AML)
Previous studies have reported that the early response to induction therapy in AML is an independent predictor of subsequent complete remission (CR) and is associated with the long-term outcome [2, 3]
This study aimed to evaluate whether 18F-FLT PET/computed tomography (CT) is suitable for assessment of the early response to induction chemotherapy and is helpful for predicting prognosis in patients with AML
Summary
We evaluated the suitability of 18F-fluorodeoxythymidine (18F-FLT) positron emission tomography (PET)/ computed tomography (CT) for assessment of the early response to induction therapy and its value for predicting clinical outcome in patients with acute myeloid leukemia (AML). Acute myeloid leukemia (AML) is a biologically and clinically heterogeneous disease with a distinct response to treatment and clinical outcome. Assessment of the response to induction therapy is important for defining chemosensitivity and for planning subsequent treatment and can be valuable in predicting prognosis in patients with AML. Previous studies have reported that the early response to induction therapy in AML is an independent predictor of subsequent complete remission (CR) and is associated with the long-term outcome [2, 3]. The predictive value of the interim BM assessment for achieving CR varies in sensitivity
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