Clinical value of diffusely increased bone marrow ¹⁸F-FDG uptake in patients with newly diagnosed diffuse large B-cell lymphoma

Abstract

Objective To investigate the clinical value of diffusely increased bone marrow ¹⁸F-fluorodeoxyglucose ( ¹⁸F-FDG) uptake in patients with newly diagnosed diffuse large B-cell lymphoma (DLBCL).

Methods A retrospective analysis was performed on the clinical data of 114 inpatients who underwent positron emission tomography (PET)/computed tomography examination and were newly diagnosed with DLBCL. All patients underwent bone marrow biopsy. The Chi-square test was used to analyze categorical data, and the t-test or Wilcoxon test was used to analyze continuous data.

Results According to the type of bone marrow ¹⁸F-FDG uptake, the patients were divided into normal bone marrow group (nPET, 51.8%), only focal group (fPET, 10.5%), only diffuse group (odPET, 28.1%), and focal + diffuse group (f + dPET, 9.6%), with proportions of bone marrow involvement of 0%, 100%, 15.6%, and 100%, respectively, and proportions of stage IV lymphoma of 33.9%, 100%, 59.4%, and 100%, respectively. Compared with the nPET patients, the odPET patients were significantly younger (57 ± 17 y vs 70 ± 13 y), and had a significantly lower hemoglobin level (108.1 ± 23.8 g/dL vs 119.4 ± 19.0 g/dL) and significantly higher proportions of stage IV lymphoma and B symptoms (59.4%, 46.9% vs 33.9%, 22.0%, all P < 0.05). There were no significant differences in sex ratio, white blood cell count, frequency of lactate dehydrogenase (LDH) increase, and the proportion of International Prognostic Index (IPI) score > 2.

Conclusion Among patients with newly diagnosed DLBCL, patients with diffusely increased bone marrow ¹⁸F-FDG uptake are younger than those with normal bone marrow ¹⁸F-FDG uptake. They are more prone to bone marrow involvement, stage IV lymphoma, anemia, B symptoms, elevated LDH, and IPI score > 2, which suggest a more serious condition and possibly worse prognosis.

Abstract

摘要： 目的 探讨初诊弥漫大B细胞淋巴瘤(Diffuse large B-cell lymphoma, DLBCL)患者骨髓摄取氟代脱氧葡萄糖 (FDG)弥漫增高征象的临床价值。 方法 回顾性分析在我院行PET/CT检查的114例初诊DLBCL住院患者。所有患 者均行骨髓活检(Bone marrow biopsy, BMB)。计数数据分析用 χ ² 检验, 计量数据分析用 t检验或Wilcoxon检验。 结果 根据骨髓摄取FDG类型分为骨髓正常组(51.8%)、单纯局灶组(10.5%)、单纯弥漫组(28.1%)、弥漫+局灶组 (9.6%), 诊断骨髓受累的比例分别为0%、100%、15.6%和100%, IV期的比例分别为33.9%、100%、59.4%、100%。单 纯弥漫组患者比骨髓正常组更年轻(57 ± 17 岁 vs 70 ± 13岁)、血红蛋白(Haemoglobin, HGB)水平更低(108.1 ± 23.8 g/dL vs 119.4 ± 19.0 g/dL)、IV期和B症状发生频率更高(59.4%和46.9% vs 33.9%和22.0%)差异有统计学意义, ( P < 0.05); 性别比例、白细胞计数(White blood cell, WBC)、乳酸脱氢酶(Lactate dehydrogenase, LDH)升高率、国际预后指 数(IPI)评分> 2比例无统计学差异。 结论 DLBCL初诊患者中, 骨髓摄取FDG弥漫增高患者比骨髓摄取FDG正常 者更年轻, 更容易发生骨髓受累、分为IV期, 更容易出现贫血、B症状、LDH升高、IPI评分> 2,这些提示其病情更重、预后可能更差。