Differential metabolic response to chemotherapy between non-Hodgkin's lymphoma and Hodgkin's lymphoma

초록

Objectives This study was evaluated to compare the early change of F-18 FDG uptake between non-Hodgkin's lymphoma (NHL) and Hodgkin's lymphoma (HL). Methods Fifty-one patients with a newly diagnosed and histologically proven aggressive NHL (n=41) and HL (n=10) were prospectively enrolled. Inclusion criteria were as follows: adult younger than 75 years; diagnosis of aggressive NHL or HL as determined by a hitological and immunochemical review; measurable lesion; ECOG performance status of 0-2 and presence; Exclusion criteria were the following: meningeal involvement or primary CNS lymphoma; positive serology for human immunodeficiency virus; concomitant or previous cancer; congestive heart failure; hepatic or renal insufficiency. The protocol was approved by our Institutional Review Board and all patients gave informed written consent. F-18 FDG PET was performed before to chemotherapy (baseline) and then was repeated at day 5, the end of the first cycle(D5) and at the end of 4 cycles (after 4 cycle). Maximal standard uptake values (max SUV) of highest region of interest (ROI) at baseline (baseline SUV), D5 (D5 SUV) and after 4 cycle (after 4 cycle SUV). Reduction index was calculated. (RI arly (%) = baseline SUV- D5 SUV / baseline SUV) x 100, RI late (%) = R5 SUV- after 4 cycle SUV/R5 SUV x 100). Results The mean (SD) of Rlearly and Rllate for 41 NHL patients were 95.6 (3.96) and 4.4(1.78) respectively. The mean (SD) of Rlearly and Rllate for 10 HL patients were 21.9(6.47) and 78.1 (4.69) respectively. Conclusions Compared to NHL patients, HL patients were shown persistently higher uptake of F-18 FDG immediately after first cycle of chemotherapy. This result suggested that higher FDG uptake of HL might be related to activated macrophage, not tumor cell.