PF618 PROGNOSTIC IMPACT OF 18F‐FDG PET/CT IN PATIENTS WITH MULTIPLE MYELOMA PRESENTING WITH RENAL IMPAIRMENT

Abstract

Background:18F‐fluorodeoxyglucose (18F‐FDG) positron emission tomography/computed tomography (PET/CT) has become a standard imaging technique for predicting prognosis in multiple myeloma (MM), but have potential inaccuracies in patients with renal impairment (RI).Aims:In this study, we investigated the prognostic role of 18F‐FDG PET/CT in patients with MM presenting with RI.Methods:Retrospective data for 74 patients with MM and RI between March 2012 and March 2017 were analyzed. Renal function was assessed using the estimated glomerular filtration rate (eGFR), which was calculated by the simplified Modification of Diet in Renal Disease (MDRD) formula. RI was defined as an eGFR of <60 mL/min/1.73 m2 at initial diagnosis. Severe RI was defined as eGFR <30 mL/min/1.73 m2. 18F‐FDG PET/CT was performed prior to induction therapy and PET/CT positivity was defined as the presence of more than three focal lesion (FL) or the presence of extramedullary disease (EMD).Results:A total of 29 patients (39.2%) had more than three FLs and 12 (16.2%) had EMD on baseline 18F‐FDG PET/CT. Thirty patients (40.5%) demonstrated PET/CT positivity. The median eGFR was 37.9 mL/min (range 3.0–59.8) and 24 (32.4%) had severe RI at initial diagnosis. Over the median follow‐up duration of 37.5 months, 54 patients (73.0%) had progressed and 22 (29.7%) had died by the time of the last follow‐up visit. The median progression free survival (PFS) was 24.2 months (95% CI, 17.4–31.1) and the median overall survival (OS) was 68.3 months (95% CI, 44.1–92.5). Patients with PET/CT positivity had significantly inferior survival outcomes than those with PET/CT negativity (PFS, 12.7 months vs. 34.0 months, P < 0.001; OS, 42.5 months vs. not reached, P = 0.012). In patients with severe RI, PET/CT positivity was significantly associated with poorer PFS and OS (PFS, 12.7 months vs 34.4 months, P = 0.011; OS, 42.4 vs not reached, P = 0.081). By multivariate analyses, PET/CT positivity was independently prognostic factor for PFS and OS in total patients.Summary/Conclusion:18F‐FDG PET/CT may be useful imaging technique for predicting survival outcomes in patients with MM presenting with RI.image