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Si us plau utilitzeu sempre aquest identificador per citar o enllaçar aquest document: https://hdl.handle.net/2445/219586
The Value of Bone Marrow Assessment by FDG PET/CT, Biopsy and Aspirate in the Upfront Evaluation of Mantle Cell Lymphoma: A Nationwide Cohort Study
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Background: Assessment of bone marrow infiltration (BMI) is part of the initial staging of mantle cell lymphoma (MCL), although BMI evaluated by biopsy (BMB) is not considered significant in the MIPI scales, and standardized recommendations remain lacking. Objectives: To evaluate the accuracy and prognostic impact of BMI assessed by PET/CT and BMB in a large series of MCL patients. Methods: We deconstructed the IPI-NCCN, MIPI, and MIPI-c indices and considered BMI as positive if indicated by a BMB, PET/CT scan, or a combination of both. Results: In the total cohort (n = 148), 110 patients had BMI detected by BMB and 33 by PET/CT. The sensitivity of BMB was higher than that of PET/CT (94.8% vs. 28.4%), as were its negative predictive value (84.2% vs. 27.8%) and accuracy (95.9% vs. 43.9%). In the total cohort, BMI detected by PET/CT showed a significant predictive value for PFS (p = 0.027), while BMB demonstrated independent prognostic value only in combination with PET/CT (p = 0.025). Among intensively treated patients (n = 128), PET/CT had significant clinical impact on PFS (p = 0.030), and when combined with BMB, it provided independent prognostic value for both PFS and OS (p = 0.026 and p = 0.033, respectively). Based on these findings, we propose a prognostic model (MCL-PET-I) that incorporates BMI by PET/CT, allowing for the identification of three groups with distinct clinical outcomes (p < 0.0001 for PFS and p = 0.00025 for OS). Conclusions: In the upfront work of MCL, PET/CT-based BMI has greater prognostic impact, while BMB remains essential for staging. We propose the MCL-PET-I prognostic index, which effectively differentiates between clinical risk groups.
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RÓDENAS QUIÑONERO, Isabel, MARCO AYALA, Javier, CHEN LIANG, Tzu hua, CRUZ VICENTE, Fátima de la, BAUMANN, Tycho, NAVARRO, José tomás, MARTÍN GARCÍA-SANCHO, Alejandro, MARTIN SANTOS, Taida, LÓPEZ JIMÉNEZ, Javier, ANDREU, Rafael, PARRA, Ester, USAS, Andrea, ALONSO, David, FERNÁNDEZ GONZÁLEZ, Marta, PALOMO RUMSCHISKY, Pablo, FRUTOS, Laura, NAVARRO, José luis, ALVAREZ PEREZ, Rosa maría, SARANDESES, Pilar, CORTES, Montserrat, TAMAYO, Pilar, UÑA, Jon, MARTÍNEZ LORCA, Alberto, RUIZ, Cristina, LOZANO, María luisa, ORTUÑO, Francisco josé. The Value of Bone Marrow Assessment by FDG PET/CT, Biopsy and Aspirate in the Upfront Evaluation of Mantle Cell Lymphoma: A Nationwide Cohort Study. _Cancers_. 2024. Vol. 16, núm. 24. [consulta: 26 de febrer de 2026]. ISSN: 2072-6694. [Disponible a: https://hdl.handle.net/2445/219586]