Prognostic impact of extranodal disease on PET/CT in follicular lymphoma: results from a validation study with ECOG 2408

Abstract: Parameters detected by positron emission tomography (PET) are not included in the usual predictive indices for follicular lymphoma (FL). Data are lacking regarding PET extranodal (EN) factors that predict outcomes in FL. PET scans from 258 patients with untreated grade 1 to 3A FL included...

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Main Authors: Frederique St-Pierre, Stephen M. Broski, Zequn Sun, Masha Kocherginsky, Betsy LaPlant, Matthew J. Maurer, Andrew Quon, Lucia Baratto, Hatice Savas, Lale Kostakoglu, Jane N. Winter, Thomas E. Witzig, Brad Kahl, Andrew M. Evens, Leo I. Gordon
Format: Article
Language:English
Published: Elsevier 2025-08-01
Series:Blood Neoplasia
Online Access:http://www.sciencedirect.com/science/article/pii/S2950328025000482
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author Frederique St-Pierre
Stephen M. Broski
Zequn Sun
Masha Kocherginsky
Betsy LaPlant
Matthew J. Maurer
Andrew Quon
Lucia Baratto
Hatice Savas
Lale Kostakoglu
Jane N. Winter
Thomas E. Witzig
Brad Kahl
Andrew M. Evens
Leo I. Gordon
author_facet Frederique St-Pierre
Stephen M. Broski
Zequn Sun
Masha Kocherginsky
Betsy LaPlant
Matthew J. Maurer
Andrew Quon
Lucia Baratto
Hatice Savas
Lale Kostakoglu
Jane N. Winter
Thomas E. Witzig
Brad Kahl
Andrew M. Evens
Leo I. Gordon
author_sort Frederique St-Pierre
collection DOAJ
description Abstract: Parameters detected by positron emission tomography (PET) are not included in the usual predictive indices for follicular lymphoma (FL). Data are lacking regarding PET extranodal (EN) factors that predict outcomes in FL. PET scans from 258 patients with untreated grade 1 to 3A FL included in the E2408 randomized phase 2 trial were reviewed. Validation of the prognostic significance of PET factors identified in a previous retrospective study was performed. PET factors with a significant impact on survival outcomes were combined with significant FL International Prognostic Index 2 (FLIPI-2) factors to evaluate the predictive value of a PET-based prognostic index. Presence of ≥2 EN sites and skin/soft tissue involvement on PET were validated as predictors of overall survival. These factors were combined with all FLIPI-2 factors except “positive bone marrow biopsy” to form a PET-based prognostic score. This novel score identified a group of patients at high risk of progression of disease at 24 months. This PET-based score did not perform better than the traditional FLIPI-2 on additional analysis. Presence of ≥2 EN sites and skin/soft tissue involvement on PET predict poor outcomes in untreated FL. Further studies should be performed to determine the validity of a PET-based prognostic index in FL.
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spelling doaj-art-827fb1f3e6884edb9c0109ee88e93fcd2025-08-20T03:55:59ZengElsevierBlood Neoplasia2950-32802025-08-012310011310.1016/j.bneo.2025.100113Prognostic impact of extranodal disease on PET/CT in follicular lymphoma: results from a validation study with ECOG 2408Frederique St-Pierre0Stephen M. Broski1Zequn Sun2Masha Kocherginsky3Betsy LaPlant4Matthew J. Maurer5Andrew Quon6Lucia Baratto7Hatice Savas8Lale Kostakoglu9Jane N. Winter10Thomas E. Witzig11Brad Kahl12Andrew M. Evens13Leo I. Gordon14Division of Hematology/Oncology, Department of Medicine, Northwestern University Feinberg School of Medicine and Robert H. Lurie Comprehensive Cancer Center, Northwestern University, Chicago, ILDivision of Nuclear Radiology, Department of Radiology, Mayo Clinic, Rochester, MNDivision of Biostatistics, Department of Preventive Medicine, Northwestern University Feinberg School of Medicine and Robert H. Lurie Comprehensive Cancer Center, Northwestern University, Chicago, ILDivision of Biostatistics, Department of Preventive Medicine, Northwestern University Feinberg School of Medicine and Robert H. Lurie Comprehensive Cancer Center, Northwestern University, Chicago, ILDivision of Biomedical Statistics and Informatics, Department of Health Sciences Research, Mayo Clinic, Rochester, MNDivision of Biomedical Statistics and Informatics, Department of Health Sciences Research, Mayo Clinic, Rochester, MNDivision of Nuclear Radiology, Department of Radiology, University of California Los Angeles, Los Angeles, CADepartment of Radiology, Stanford University, Stanford, CADivision of Nuclear Medicine, Department of Radiology, Northwestern University Feinberg School of Medicine and Robert H. Lurie Comprehensive Cancer Center, Northwestern University, Chicago, ILDepartment of Radiology and Medical Imaging, University of Virginia, Charlottesville, VADivision of Hematology/Oncology, Department of Medicine, Northwestern University Feinberg School of Medicine and Robert H. Lurie Comprehensive Cancer Center, Northwestern University, Chicago, ILDivision of Hematology, Department of Medicine, Mayo Clinic, Rochester, MNDivision of Oncology, Department of Medicine, Washington University School of Medicine and Siteman Cancer Center, St Louis, MODivision Blood Disorders, Rutgers Cancer Institute of New Jersey, New Brunswick, NJDivision of Hematology/Oncology, Department of Medicine, Northwestern University Feinberg School of Medicine and Robert H. Lurie Comprehensive Cancer Center, Northwestern University, Chicago, IL; Correspondence: Leo I. Gordon, Division of Hematology/Oncology, Robert H. Lurie Comprehensive Cancer Center, Northwestern University Feinberg School of Medicine, 675 N St Clair St, Suite 85o, Chicago, IL 60611;Abstract: Parameters detected by positron emission tomography (PET) are not included in the usual predictive indices for follicular lymphoma (FL). Data are lacking regarding PET extranodal (EN) factors that predict outcomes in FL. PET scans from 258 patients with untreated grade 1 to 3A FL included in the E2408 randomized phase 2 trial were reviewed. Validation of the prognostic significance of PET factors identified in a previous retrospective study was performed. PET factors with a significant impact on survival outcomes were combined with significant FL International Prognostic Index 2 (FLIPI-2) factors to evaluate the predictive value of a PET-based prognostic index. Presence of ≥2 EN sites and skin/soft tissue involvement on PET were validated as predictors of overall survival. These factors were combined with all FLIPI-2 factors except “positive bone marrow biopsy” to form a PET-based prognostic score. This novel score identified a group of patients at high risk of progression of disease at 24 months. This PET-based score did not perform better than the traditional FLIPI-2 on additional analysis. Presence of ≥2 EN sites and skin/soft tissue involvement on PET predict poor outcomes in untreated FL. Further studies should be performed to determine the validity of a PET-based prognostic index in FL.http://www.sciencedirect.com/science/article/pii/S2950328025000482
spellingShingle Frederique St-Pierre
Stephen M. Broski
Zequn Sun
Masha Kocherginsky
Betsy LaPlant
Matthew J. Maurer
Andrew Quon
Lucia Baratto
Hatice Savas
Lale Kostakoglu
Jane N. Winter
Thomas E. Witzig
Brad Kahl
Andrew M. Evens
Leo I. Gordon
Prognostic impact of extranodal disease on PET/CT in follicular lymphoma: results from a validation study with ECOG 2408
Blood Neoplasia
title Prognostic impact of extranodal disease on PET/CT in follicular lymphoma: results from a validation study with ECOG 2408
title_full Prognostic impact of extranodal disease on PET/CT in follicular lymphoma: results from a validation study with ECOG 2408
title_fullStr Prognostic impact of extranodal disease on PET/CT in follicular lymphoma: results from a validation study with ECOG 2408
title_full_unstemmed Prognostic impact of extranodal disease on PET/CT in follicular lymphoma: results from a validation study with ECOG 2408
title_short Prognostic impact of extranodal disease on PET/CT in follicular lymphoma: results from a validation study with ECOG 2408
title_sort prognostic impact of extranodal disease on pet ct in follicular lymphoma results from a validation study with ecog 2408
url http://www.sciencedirect.com/science/article/pii/S2950328025000482
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