The relationship between bone marrow activity detected on PET / CT and prognosis in patients with lymphoma

Aim: In this study, we aimed to evaluate the relationship between survival of patients with lymphoma who were considered to benegative for bone marrow (BM) infiltration and BM FDG uptake on PET / CT.Material and Methods: This retrospective study included 55 patients diagnosed with lymphoma (33 HL and 22 NHL), with no BMinfiltration (by biopsy or clinically negative) and having pre-treatment PET / CT. According to the pattern of BM FDG uptake on PET/ CT the patients were divided into three groups as; those with focal FDG uptake (F-FDG), those with diffuse increased FDG uptake(D-FDG) and those with normal FDG uptake (N-FDG). The overall survival (OS) and progression-free survival (PFS) curves of thepatients were plotted with Kaplan Meier method. The OS and PS of patients who were grouped according to the pattern of BM FDGuptake on PET / CT, gender, disease stage and lymphoma type were compared with Log Rank test.Results: The mean follow-up period of our study was 23.7 ± 2.1 months (1-53 months). The mean OS was 41.9 ± 2.8 months, andthe mean PFS was 37.8 ± 3 months. Ten patients showed focal or multifocal FDG uptake of BM on PET / CT (F-FDG). 28 patientshad diffuse increased FDG uptake in the BM (D-FDG). In 17 patients, BM FDG uptake was within normal limits (N-FDG). There wasno significant difference between OS and PFS of patients grouped according to gender, stage of disease, type of lymphoma and BMFDG uptake pattern (p> 0.05). Older age was associated with shorter OS and PFS.Conclusion: In our study, no significant relationship was found between BM FDG uptake on PET / CT and survival of patients withlymphoma with negative BM infiltration. However, although PET / CT does not completely replace BM biopsy, it may be helpful indetecting early infiltration of BM.

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