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• W3022223377 abstract "160 Objectives: To characterize the extent and location of metabolically active extramedullary disease (chloromas) in pediatric patients with acute myelogenous leukemia (AML) using FDG PET/CT. Methods: From an institutional database search, we identified 170 patients with AML who underwent Diagnostic Imaging evaluations. Of these, 54 patients FDG PET/CT imaging for clinical management from April 2002 until July 2018. 36 patients had 1 scan, 4 had 2 scans, 7 had 3 scans, 3 had 4 scans, 2 had 5 scans, and 1 patient each had 6, 7, and 8 scans for a total of 108 scans. 33 Scans to evaluate for chloromas before bone marrow transplantation were conducted in 32 total patients. 27 scans were prompted by clinical suspicion of chloroma, and 48 scans were for clinical follow up of chloromas. FDG PET/CT scans were performed ~ 60 min following injection of 0.14mCi/kg 18F-FDG intravenously. Images were obtained from the top of the head through the feet. Images and reports were reviewed for the presence of foci of abnormal uptake consistent with extramedullary disease involvement. Confirmation of disease was made by biopsy (n= 23) in 16 patients. Diagnosis was confirmed using other imaging modalities and clinical followup in the remaining cases. Comparison was made with minimal residual disease (MRD) assessments by flow cytometry. Results: 30 patients (19 male, 11 female) had FDG PET/CT evidence for chloromas. Common sites of involvement were soft tissue (n=24) including 4 with mediastinal masses, CNS (n=23), skeletal (n=18), lymph nodes (n=11), and cutaneous (n=6). In 19 patients, chloromas were clinically occult prior to FDG PET/CT imaging. In 7 patients with chloromas, MRD assessment was negative, but subsequently became positive indicating bone marrow relapse. The prognosis for patients with chloromas is quite poor. The American Society of Clinical Oncology (ASCO) estimates the 5-year survival of pediatric AML cases, across all subtypes, is 65%. Only 50% of our pediatric patients with chloromas lived past 1.5 years after their diagnosis with AML. It is possible that these chloromas may serve as a ‘reservoir’ of treatment resistant blast cells, which if not eliminated, migrate back to the bone marrow and repopulate to cause systemic relapse. Conclusions: In our population of pediatric patients with AML, chloromas are not uncommon, have poor prognoses, are often multifocal and occult, and may serve as a reservoir to cause relapse. Chloromas may be present despite negative MRD findings. FDG PET/CT is a very useful imaging modality for the detection and response evaluation of extramedullary disease in these patients." @default.
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• W3022223377 date "2019-05-01" @default.
• W3022223377 modified "2023-09-24" @default.
• W3022223377 title "FDG PET-CT for the characterization of extramedullary disease in pediatric patients with acute myelogenous leukemia" @default.
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