Multipl miyelomda IMPeTUS kriterlerinden elde edilen PET skorunun prognostik önemi

Abstract

Amaç Multipl myelom (MM), kemik iliği, kemik ve bazen ekstramedüller bölgeleri infiltre eden klonal bir plazma hücre malignitesidir. Hastaların yönetimi için güvenilir evreleme ve prognostik faktörler gereklidir. Görüntüleme yöntemleri, özellikle [18F]FDG PET/BT, hastalığın yaygınlığını değerlendirmede kritik rol oynar. Bu çalışma, MM'de progresyonsuz sağkalımı (PFS) öngörmek için IMPeTUS kriterlerine dayalı bir puanlama sistemini değerlendirmektedir. Gereç ve Yöntemler Bu çalışmaya, yeni tanı almış ve tedavi edilmemiş 35 MM hastası (13 kadın, 22 erkek) dahil edilmiştir. Tanıdan sonraki bir ay içinde hastalara başlangıç [18F]FDG PET/BT taramaları yapılmıştır. MM tipi, ISS evresi, kemoterapi rejimleri ve hasta sonuçlarına ilişkin veriler toplanmıştır. PET/BT görüntüleri IMPeTUS kriterlerine göre değerlendirilmiş ve özellikle kemik iliği ile lezyonlar için Deauville 5 puanlı skorlama sistemi kullanılmıştır. Bulgular Kohortun ortalama yaşı 65 idi. En yaygın MM tipi Ig G kappa olarak saptandı (%37.1). Difüz kemik iliği tutulumu ve fokal lezyonlar sırasıyla hastaların %37.2 ve %57.2’sinde gözlendi (DS ≥ 4). PET skoru için 6.5 eşik değeri, PFS’yi %61.5 duyarlılık ve %72.7 özgüllükle öngördü (EAA: 0.715). PET skoru < 6.5 olan hastalar ile ≥ 6.5 olan hastalar arasında ortanca PFS açısından anlamlı fark bulundu (35 ± 4.1 ay vs. 23.6 ± 4.03 ay, p = 0.027). Sonuçlar PET skoru için belirlenen 6.5 eşik değeri, MM’de prognostik bir belirteç olarak kullanılabilir ve hasta sınıflandırması ile tedavi kararlarına katkı sağlayabilir.

Keywords

• Anahtar Kelimeler: Multipl Myelom
• PET skoru
• IMPeTUS kriterleri
• Deauville

Prognostic importance of PET score obtained from IMPeTUS criteria in multiple myeloma

Abstract

Aim Multiple myeloma (MM) is a clonal plasma cell malignancy that infiltrates the bone marrow, bone, and sometimes extramedullary sites. Reliable staging and prognostic factors are essential for patient management. Imaging modalities, especially [18F]FDG PET/CT, are essential for the assessment of disease extent. This study evaluates a scoring system based on the IMPeTUs criteria for predicting progression-free survival (PFS) in MM. Materials and Methods This study included 35 newly diagnosed, treatment-naive MM patients (13 females, 22 males). Baseline [18F]FDG PET/CT scans were obtained within one month of diagnosis. Data on MM type, ISS stage, chemotherapy regimens and outcomes were collected. PET/CT scans were evaluated using the IMPeTUs criteria, focusing on the Deauville 5-point scoring system for bone marrow and lesions. Results The mean age of the cohort was 65 years. Ig G kappa was the most common MM type (37.1%). Diffuse bone marrow uptake and focal lesions were observed in 37.2% and 57.2% of patients, respectively, DS ≥ 4. The PET score cut-off of 6.5 predicted PFS with 61.5% sensitivity and 72.7% specificity (AUC 0.715). Median PFS was significantly different between patients with PET score < 6.5 and ≥ 6.5 (35 ± 4.1 months vs. 23.6 ± 4.03 months, p = 0.027). Conclusions The PET score cut-off value of 6.5 serves as a potential prognostic tool for MM, aiding in patient stratification and treatment decisions.

Keywords

• Multiple Myeloma
• PET score
• IMPeTUS criteria
• Deauville

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