The prevalence of extramedullary acute myeloid leukemia detected by 18FDG-PET/CT: final results from the prospective PETAML trial
Research output: Contribution to journal › Research article › Contributed › peer-review
Contributors
Abstract
Extramedullary (EM) disease in patients with acute myeloid leukemia (AML) is a known phenomenon. Since the prevalence of EM AML has so far only been clinically determined on examination, we performed a prospective study in patients with AML. The aim of the study was to determine the prevalence of metabolically active EM AML using total body 18Fluorodesoxy-glucose positron emission tomography/computed tomography (18FDG-PET/CT) imaging at diagnosis prior to initiation of therapy. In order to define the dynamics of EM AML throughout treatment, PET-positive patients underwent a second 18FDG-PET/CT imaging series during follow up by the time of remission assessment. A total of 93 patients with AML underwent 18FDG-PET/CT scans at diagnosis. The prevalence of PET-positive EM AML was 19% with a total of 65 EM AML manifestations and a median number of two EM manifestations per patient (range, 1-12), with a median maximum standardized uptake value of 6.1 (range, 2-51.4). When adding those three patients with histologically confirmed EM AML who were 18FDG-PET/CT negative in the 18FDG-PET/CT at diagnosis, the combined prevalence for EM AML was 22%, resulting in 77% sensitivity and 97% specificity. Importantly, 60% (6 of 10) patients with histologically confirmed EM AML still had active EM disease in their follow up 18FDG-PET/CT. 18FDG-PET/CT reveals a high prevalence of metabolically active EM disease in AML patients. Metabolic activity in EM AML may persist even beyond the time point of hematologic remission, a finding that merits further prospective investigation to explore its prognostic relevance. (Trial registered at clinicaltrials.gov identifier: 01278069).
Details
Original language | English |
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Pages (from-to) | 1552-1558 |
Number of pages | 7 |
Journal | Haematologica |
Volume | 105 |
Issue number | 6 |
Publication status | Published - Jun 2020 |
Peer-reviewed | Yes |
External IDs
PubMedCentral | PMC7271590 |
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ORCID | /0000-0002-7017-3738/work/142253981 |
Scopus | 85085896264 |
Keywords
Keywords
- Fluorodeoxyglucose F18, Humans, Leukemia, Myeloid, Acute/diagnostic imaging, Positron Emission Tomography Computed Tomography, Positron-Emission Tomography, Prevalence, Prospective Studies, Radiopharmaceuticals, Sensitivity and Specificity