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Goksel S, Ilkkilic K, Bulbul O, Akdogan E. Relation of whole-body metabolic tumor volume and total lesion glycolysis on fluorodeoxyglucose PET/computed tomography with clinical and laboratory parameters in newly diagnosed multiple myeloma. Nucl Med Commun 2022; 43:1077-1083. [PMID: 36006402 DOI: 10.1097/mnm.0000000000001608] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
OBJECTIVE This study aims to evaluate the relationships of metabolic fluorodeoxyglucose PET/computed tomography (FDG PET/CT) parameters such as whole-body metabolic tumor volume (WB MTV), WB-total lesion glycolysis (TLG), and bone marrow (BM)-mean standard uptake value (SUVmean) with clinical stage and other prognostic biomarkers in newly diagnosed multiple myeloma (MM) patients. METHODS Patients who underwent pretreatment PET/CT with the diagnosis of MM were evaluated retrospectively. The number of focal lesions, WB MTV, WB TLG, and BM SUVmean values were measured on FDG PET/CT images. Clinical stages and prognostic laboratory parameters were recorded the pretreatment period. RESULTS WB MTV and WB TLG values were significantly higher in patients with more than three focal lesions on FDG PET/CT scan (all P < 0.001). According to the Revised International Staging System (R-ISS), all WB MTV, WB TLG, and BM SUVmean values are significantly higher in patients with stage 3 disease than in stages 1-2 ( P = 0.027, P = 0.019, P = 0.001, respectively). Serum creatinine level is positively correlated with WB MTV, WB TLG, and BM SUVmean values ( P = 0.020, P = 0.004, P < 0.001, respectively). In addition, the β2 microglobulin level, an essential biochemical prognostic parameter, was positively correlated with the BM SUVmean value ( P = 0.013). CONCLUSION The BM SUVmean, WB MTV, and WB TLG values, which reflect FDG avid WB tumor burden, are associated with prognostic biomarkers and R-ISS stage in newly diagnosed MM patients. It contributes to the identification of high-risk patients at the pretreatment staging.
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Affiliation(s)
| | - Kadir Ilkkilic
- Hematology, Faculty of Medicine, Recep Tayyip Erdoğan University, Rize, Turkey
| | | | - Elif Akdogan
- Hematology, Faculty of Medicine, Recep Tayyip Erdoğan University, Rize, Turkey
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2
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Cui J, Zou Z, Duan J, Tang W, Li Y, Zhang L, Pan L, Niu T. Predictive Values of PET/CT in Combination With Regulatory B Cells for Therapeutic Response and Survival in Contemporary Patients With Newly Diagnosed Multiple Myeloma. Front Immunol 2021; 12:671904. [PMID: 34489930 PMCID: PMC8417409 DOI: 10.3389/fimmu.2021.671904] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2021] [Accepted: 07/26/2021] [Indexed: 02/05/2023] Open
Abstract
To assess patients with multiple myeloma (MM), the whole-body positron-emission tomography/computed tomography (PET/CT) occupies a pivotal position for diagnostic stratification, response evaluation, and survival prediction, while important limitations are recognized as incapable of representing tumor microenvironment. Regulatory B cells (Bregs) have been reported to have an inhibitory immune function, contributing to bone marrow (BM)-immunosuppressive microenvironment for MM. Therefore, to investigate the role of PET/CT in combination with Bregs’ ratios to predict therapeutic response and survival, we sequentially enrolled 120 patients with newly diagnosed MM (NDMM) who were treated with novel agents in our center, while conventional PET/CT parameters including maximum standard uptake value (SUVmax), ratios of BM-derived Bregs within CD19+ B cells, and patients’ clinical characteristics were collected. After a median follow-up of 28.20 months (range 7.00–46.93 months), SUVmax > 4.2 at onset, accounting for 53.2% of NDMM, was uncovered to predict inferior progression-free survival (PFS) as well as overall survival (OS). With regard to the ratios of BM-derived Bregs within CD19+ B cells, the cohort with the Bregs’ proportions lower than 10%, accounting for 46.2%, exerted poorer OS. Additionally, the patients with both SUVmax > 4.2 and Bregs’ ratios < 10%, accounting for 31.7%, yielded compromised therapeutic response and long-term survival. Collectively, this study may draw attention on the prognostic value of combination of PET/CT and Bregs’ ratios when clinical decisions are made for MM in the era of novel agents.
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Affiliation(s)
- Jian Cui
- Department of Hematology, West China Hospital, Sichuan University, Chengdu, China.,West China School of Medicine, Sichuan University, Chengdu, China
| | - Zhongqing Zou
- Department of Hematology, West China Hospital, Sichuan University, Chengdu, China.,Department of Hematology, Clinical Medical College & Affiliated Hospital of Chengdu University, Chengdu University, Chengdu, China
| | - Jiayu Duan
- Department of Hematology, West China Hospital, Sichuan University, Chengdu, China.,West China School of Medicine, Sichuan University, Chengdu, China
| | - Wenjiao Tang
- Department of Hematology, West China Hospital, Sichuan University, Chengdu, China
| | - Yan Li
- Department of Hematology, West China Hospital, Sichuan University, Chengdu, China
| | - Li Zhang
- Department of Hematology, West China Hospital, Sichuan University, Chengdu, China
| | - Ling Pan
- Department of Hematology, West China Hospital, Sichuan University, Chengdu, China
| | - Ting Niu
- Department of Hematology, West China Hospital, Sichuan University, Chengdu, China
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3
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Fouquet G, Wartski M, Dechmi A, Willems L, Deau-Fischer B, Franchi P, Descroocq J, Deschamps P, Blanc-Autran E, Clerc J, Bouscary D, Barreau S, Chapuis N, Vignon M, Cottereau AS. Prognostic Value of FDG-PET/CT Parameters in Patients with Relapse/Refractory Multiple Myeloma before Anti-CD38 Based Therapy. Cancers (Basel) 2021; 13:4323. [PMID: 34503133 PMCID: PMC8431719 DOI: 10.3390/cancers13174323] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2021] [Revised: 08/25/2021] [Accepted: 08/25/2021] [Indexed: 11/16/2022] Open
Abstract
Although anti-CD38 monoclonal antibodies have improved the prognosis of relapsed/refractory multiple myeloma (RRMM), some patients still experience early relapses with poor outcomes. This present study evaluated the predictive value of FDG PET/CT parameters for RRMM prior to initiating anti-CD38 treatment. We included 38 consecutive RRMM patients who underwent a PET/CT scan treated at our institution at relapse. The median PFS was 12.5 months and the median OS was not reached. 42% of the patients had an initial ISS score of 1, 37% of 2, and 21% of 3. The presence of >3 focal lesions (FLs, n = 19) and the ISS score were associated with inferior PFS (p = 0.0036 and p = 0.0026) and OS (p = 0.025 and p = 0.0098). Patients with >3 FLs had a higher initial ISS score (p = 0.028). In multivariable analysis, the ISS score and >3 FLs were independent prognostic factors for PFS (p = 0.010 and p = 0.025 respectively), and combined they individualized a high-risk group with a median PFS and OS of 3.1 months and 8.5 months respectively vs. not reached for the other patients. The presence of >3 FLs on PET was predictive of survival outcomes in patients with RRMM treated using CD38 targeted therapy. Combined with the initial ISS, an ultra-high-risk RRMM population can thus be identified.
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Affiliation(s)
- Guillemette Fouquet
- Assistance Publique-Hôpitaux de Paris Centre, Université de Paris, Service d’Hématologie Clinique, Hôpital Cochin, 75014 Paris, France; (G.F.); (L.W.); (B.D.-F.); (P.F.); (J.D.); (P.D.); (D.B.); (M.V.)
| | - Myriam Wartski
- Assistance Publique-Hôpitaux de Paris Centre, Université de Paris, Service de Médecine Nucléaire, Hôpital Cochin, 75014 Paris, France; (M.W.); (A.D.); (J.C.)
| | - Amina Dechmi
- Assistance Publique-Hôpitaux de Paris Centre, Université de Paris, Service de Médecine Nucléaire, Hôpital Cochin, 75014 Paris, France; (M.W.); (A.D.); (J.C.)
| | - Lise Willems
- Assistance Publique-Hôpitaux de Paris Centre, Université de Paris, Service d’Hématologie Clinique, Hôpital Cochin, 75014 Paris, France; (G.F.); (L.W.); (B.D.-F.); (P.F.); (J.D.); (P.D.); (D.B.); (M.V.)
| | - Bénédicte Deau-Fischer
- Assistance Publique-Hôpitaux de Paris Centre, Université de Paris, Service d’Hématologie Clinique, Hôpital Cochin, 75014 Paris, France; (G.F.); (L.W.); (B.D.-F.); (P.F.); (J.D.); (P.D.); (D.B.); (M.V.)
| | - Patricia Franchi
- Assistance Publique-Hôpitaux de Paris Centre, Université de Paris, Service d’Hématologie Clinique, Hôpital Cochin, 75014 Paris, France; (G.F.); (L.W.); (B.D.-F.); (P.F.); (J.D.); (P.D.); (D.B.); (M.V.)
| | - Justine Descroocq
- Assistance Publique-Hôpitaux de Paris Centre, Université de Paris, Service d’Hématologie Clinique, Hôpital Cochin, 75014 Paris, France; (G.F.); (L.W.); (B.D.-F.); (P.F.); (J.D.); (P.D.); (D.B.); (M.V.)
| | - Paul Deschamps
- Assistance Publique-Hôpitaux de Paris Centre, Université de Paris, Service d’Hématologie Clinique, Hôpital Cochin, 75014 Paris, France; (G.F.); (L.W.); (B.D.-F.); (P.F.); (J.D.); (P.D.); (D.B.); (M.V.)
| | - Estelle Blanc-Autran
- Hôpital Marie Lannelongue, Service de Médecine Nucléaire, 92350 Le Plessis-Robinson, France;
| | - Jérôme Clerc
- Assistance Publique-Hôpitaux de Paris Centre, Université de Paris, Service de Médecine Nucléaire, Hôpital Cochin, 75014 Paris, France; (M.W.); (A.D.); (J.C.)
| | - Didier Bouscary
- Assistance Publique-Hôpitaux de Paris Centre, Université de Paris, Service d’Hématologie Clinique, Hôpital Cochin, 75014 Paris, France; (G.F.); (L.W.); (B.D.-F.); (P.F.); (J.D.); (P.D.); (D.B.); (M.V.)
| | - Sylvain Barreau
- Assistance Publique-Hôpitaux de Paris Centre, Université de Paris, Service D’hémato-Biologie, Hôpital Cochin, 75014 Paris, France; (S.B.); (N.C.)
| | - Nicolas Chapuis
- Assistance Publique-Hôpitaux de Paris Centre, Université de Paris, Service D’hémato-Biologie, Hôpital Cochin, 75014 Paris, France; (S.B.); (N.C.)
| | - Marguerite Vignon
- Assistance Publique-Hôpitaux de Paris Centre, Université de Paris, Service d’Hématologie Clinique, Hôpital Cochin, 75014 Paris, France; (G.F.); (L.W.); (B.D.-F.); (P.F.); (J.D.); (P.D.); (D.B.); (M.V.)
| | - Anne-Ségolène Cottereau
- Assistance Publique-Hôpitaux de Paris Centre, Université de Paris, Service de Médecine Nucléaire, Hôpital Cochin, 75014 Paris, France; (M.W.); (A.D.); (J.C.)
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Positron Emission Tomography (PET) Imaging of Multiple Myeloma in a Post-Treatment Setting. Diagnostics (Basel) 2021; 11:diagnostics11020230. [PMID: 33546455 PMCID: PMC7913723 DOI: 10.3390/diagnostics11020230] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2020] [Revised: 01/23/2021] [Accepted: 01/29/2021] [Indexed: 12/01/2022] Open
Abstract
2-deoxy-2-[18F]fluoro-D-glucose (FDG) positron emission tomography/computed tomography (FDG PET/CT) has an established clinical value in the diagnosis and initial staging of multiple myeloma (MM). In the last ten years, a vast body of literature has shown that this tool can also be of high relevance for monitoring therapy responses, making it the recommended imaging approach in this field. Starting from the strengths and weaknesses of radiological imaging in MM, the present review aims to analyze FDG PET/CT’s current clinical value focusing on therapy response assessment and objective interpretation criteria for therapy monitoring. Given the potential occurrence of patients with MM showing non-FDG-avid bone disease, new opportunities can be provided by non-FDG PET tracers. Accordingly, the potential role of non-FDG PET tracers in this setting has also been discussed.
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Han S, Woo S, Kim YI, Yoon DH, Ryu JS. Prognostic value of 18F-fluorodeoxyglucose positron emission tomography/computed tomography in newly diagnosed multiple myeloma: a systematic review and meta-analysis. Eur Radiol 2020; 31:152-162. [PMID: 32809165 DOI: 10.1007/s00330-020-07177-x] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2020] [Revised: 06/18/2020] [Accepted: 08/10/2020] [Indexed: 12/13/2022]
Abstract
OBJECTIVES We performed a systematic review and meta-analysis on the prognostic values of 18F-FDG PET/CT in patients with newly diagnosed multiple myeloma (MM). METHODS PubMed and Embase were searched until July 10, 2019, for studies that reported the prognostic significance of 18F-FDG PET in patients with newly diagnosed MM, with overall (OS) and progression-free survival (PFS) included as outcomes. Hazard ratios (HRs) and their 95% confidence intervals (CIs) were meta-analytically pooled using a random-effects model. RESULTS Fifteen studies (1670 patients) were included for qualitative synthesis. Among multiple PET parameters, the presence of extramedullary disease (EMD), more than three focal lesions (FLs), and high FDG uptake were widely evaluated and significantly associated with shorter OS and PFS in most of the included studies. Among 11 studies included in quantitative synthesis, the overall HRs of EMD, more than three FLs, and high FDG uptake on PFS were 2.12 (95% CI, 1.52-2.96), 2.38 (95% CI, 1.84-3.07), and 2.02 (95% CI, 1.51-2.68), respectively. The pooled HRs of those three parameters on OS were 2.37 (95% CI, 1.77-3.16), 3.29 (95% CI, 2.38-4.56), and 2.28 (95% CI, 1.67-3.13). No statistical differences were found across parameters for either PFS (p = 0.6822) or OS (p = 0.2147). CONCLUSIONS Pretreatment 18F-FDG PET/CT is a significant predictor for disease progression and survival in patients with MM. It may be a useful prognostic biomarker capable of accurate risk stratification and application in clinical decision-making for newly diagnosed MM. KEY POINTS • There remain unmet clinical needs for reliable prognostic biomarkers in patients with newly diagnosed multiple myeloma. • This meta-analysis shows that the presence of extramedullary disease, more than three focal lesions, and high FDG uptake from baseline 18F-FDG PET are significant prognostic factors. • These imaging biomarkers might help the accurate stratification of patient prognosis which is required for choosing an appropriate therapeutic strategy in clinical practice.
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Affiliation(s)
- Sangwon Han
- Department of Nuclear Medicine, Asan Medical Center, University of Ulsan College of Medicine, 88 Olympic-ro 43-gil, Songpa-gu, Seoul, 05505, South Korea
| | - Sungmin Woo
- Department of Radiology, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Yong-Il Kim
- Department of Nuclear Medicine, Asan Medical Center, University of Ulsan College of Medicine, 88 Olympic-ro 43-gil, Songpa-gu, Seoul, 05505, South Korea
| | - Dok Hyun Yoon
- Department of Oncology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea
| | - Jin-Sook Ryu
- Department of Nuclear Medicine, Asan Medical Center, University of Ulsan College of Medicine, 88 Olympic-ro 43-gil, Songpa-gu, Seoul, 05505, South Korea.
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Cho A, Kwon IG, Kim S, Noh SH, Ku CR. Altered systematic glucose utilization after gastrectomy: correlation with weight loss. Surg Obes Relat Dis 2020; 16:900-907. [DOI: 10.1016/j.soard.2020.03.003] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2019] [Revised: 02/07/2020] [Accepted: 03/05/2020] [Indexed: 12/12/2022]
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7
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Visual and volumetric parameters by 18F-FDG-PET/CT: a head to head comparison for the prediction of outcome in patients with multiple myeloma. Ann Hematol 2019; 99:127-135. [DOI: 10.1007/s00277-019-03852-2] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2019] [Accepted: 11/17/2019] [Indexed: 12/22/2022]
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8
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Li X, Guo Y, Kuang X, Zhao L, Li H, Cheng B, Wang W, Zhang Z, Liu P, Wang J. Histone deacetylase inhibitor LMK-235-mediated HO-1 expression induces apoptosis in multiple myeloma cells via the JNK/AP-1 signaling pathway. Life Sci 2019; 223:146-157. [PMID: 30876940 DOI: 10.1016/j.lfs.2019.03.011] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2018] [Revised: 02/23/2019] [Accepted: 03/07/2019] [Indexed: 11/18/2022]
Abstract
AIMS Histone deacetylase inhibitors (HDACis) are promising anticancer drugs that open new areas of epigenetic drug discovery. Multiple myeloma (MM) is a malignant tumor of the blood system that is difficult to cure and often relapses. Here, we investigated the in vitro effects of a novel HDACi, LMK-235, on MM cells, and explored the underlying mechanisms. MAIN METHODS Real-time PCR and western blot were used to measure the expression of HDAC4 and HO-1 in MM cells treated with LMK-235. si-RNA was used to transfect MM cells. Hemin or ZnPP was combined to regulate heme oxygenase-1 (HO-1), and a pathway inhibitor was added to measure changes in the JNK/AP-1 signaling pathway. Apoptosis and proliferation were assessed by flow cytometry and CCK-8 assay, respectively. KEY FINDINGS We found that LMK-235, a selective inhibitor of class IIA HDAC4/5, induced apoptosis of MM cells by downregulating HO-1 that is closely related to HDAC4. LMK-235 increased phosphorylation of JNK and c -Jun in MM cells. Downregulation of HO-1 expression in combination with LMK-235 expression further activated phosphorylation of JNK and c-Jun and induced apoptosis in MM cells. When the JNK inhibitor SP600125 was used in combination, the apoptosis phenomenon was reversed. However, when HO-1 was upregulated, LMK-235-mediated phosphorylation of JNK and c-Jun was inhibited, and apoptosis of MM cells began to decrease. SIGNIFICANCE These data suggest that LMK-235 has potent anti-myeloma activity through regulation of HO-1-induced apoptosis via the JNK/AP-1 pathway. This provides a new concept for the treatment of multiple myeloma.
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Affiliation(s)
- Xinyao Li
- Guizhou Medical University, Guiyang, Guizhou, China; Department of Hematology, Affiliated Hospital of Guizhou Medical University, Guiyang, Guizhou, China; Guizhou Province Laboratory of Haematopoietic Stem Cell Transplantation Center, Guiyang, Guizhou, China
| | - Yongling Guo
- Guizhou Medical University, Guiyang, Guizhou, China; Department of Hematology, Affiliated Hospital of Guizhou Medical University, Guiyang, Guizhou, China; Guizhou Province Laboratory of Haematopoietic Stem Cell Transplantation Center, Guiyang, Guizhou, China
| | - Xingyi Kuang
- Guizhou Medical University, Guiyang, Guizhou, China; Department of Hematology, Affiliated Hospital of Guizhou Medical University, Guiyang, Guizhou, China; Guizhou Province Laboratory of Haematopoietic Stem Cell Transplantation Center, Guiyang, Guizhou, China
| | - Lu Zhao
- Guizhou Medical University, Guiyang, Guizhou, China; Department of Hematology, Affiliated Hospital of Guizhou Medical University, Guiyang, Guizhou, China; Guizhou Province Laboratory of Haematopoietic Stem Cell Transplantation Center, Guiyang, Guizhou, China
| | - Hongsong Li
- Linyi Central Hospital, Linyi, Shandong, China
| | - Bingqing Cheng
- Department of Hematology, Affiliated Hospital of Guizhou Medical University, Guiyang, Guizhou, China; Guizhou Province Laboratory of Haematopoietic Stem Cell Transplantation Center, Guiyang, Guizhou, China
| | - Weili Wang
- Guizhou Medical University, Guiyang, Guizhou, China; Department of Hematology, Affiliated Hospital of Guizhou Medical University, Guiyang, Guizhou, China; Guizhou Province Laboratory of Haematopoietic Stem Cell Transplantation Center, Guiyang, Guizhou, China
| | - Zhaoyuan Zhang
- Guizhou Medical University, Guiyang, Guizhou, China; Department of Hematology, Affiliated Hospital of Guizhou Medical University, Guiyang, Guizhou, China; Guizhou Province Laboratory of Haematopoietic Stem Cell Transplantation Center, Guiyang, Guizhou, China
| | - Ping Liu
- Guizhou Medical University, Guiyang, Guizhou, China; Department of Hematology, Affiliated Hospital of Guizhou Medical University, Guiyang, Guizhou, China; Guizhou Province Laboratory of Haematopoietic Stem Cell Transplantation Center, Guiyang, Guizhou, China
| | - Jishi Wang
- Guizhou Medical University, Guiyang, Guizhou, China; Department of Hematology, Affiliated Hospital of Guizhou Medical University, Guiyang, Guizhou, China; Guizhou Province Laboratory of Haematopoietic Stem Cell Transplantation Center, Guiyang, Guizhou, China.
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Bailly C, Carlier T, Jamet B, Touzeau C, Moreau P, Kraeber-Bodéré F, Bodet-Milin C. 18F-FDG PET/CT in multiple myeloma: critical insights and future directions. Eur J Nucl Med Mol Imaging 2019; 46:1048-1050. [PMID: 30770949 DOI: 10.1007/s00259-019-04279-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2019] [Accepted: 01/31/2019] [Indexed: 11/24/2022]
Affiliation(s)
- Clément Bailly
- CRCINA, INSERM, CNRS, Université d'Angers, Université de Nantes, Nantes, France.,Department of Nuclear Medicine, CHU de Nantes, 1 place Alexis Ricordeau, 44093, Nantes, France
| | - Thomas Carlier
- CRCINA, INSERM, CNRS, Université d'Angers, Université de Nantes, Nantes, France.,Department of Nuclear Medicine, CHU de Nantes, 1 place Alexis Ricordeau, 44093, Nantes, France
| | - Bastien Jamet
- Department of Nuclear Medicine, CHU de Nantes, 1 place Alexis Ricordeau, 44093, Nantes, France
| | - Cyrille Touzeau
- CRCINA, INSERM, CNRS, Université d'Angers, Université de Nantes, Nantes, France.,Department of Hematology, CHU de Nantes, 1 place Alexis Ricordeau, 44093, Nantes, France
| | - Philippe Moreau
- CRCINA, INSERM, CNRS, Université d'Angers, Université de Nantes, Nantes, France.,Department of Hematology, CHU de Nantes, 1 place Alexis Ricordeau, 44093, Nantes, France
| | - Françoise Kraeber-Bodéré
- CRCINA, INSERM, CNRS, Université d'Angers, Université de Nantes, Nantes, France.,Department of Nuclear Medicine, CHU de Nantes, 1 place Alexis Ricordeau, 44093, Nantes, France.,Department of Nuclear Medicine, ICO-René Gauducheau, Boulevard Jacques Monod, 44805, Saint-Herblain, France
| | - Caroline Bodet-Milin
- CRCINA, INSERM, CNRS, Université d'Angers, Université de Nantes, Nantes, France. .,Department of Nuclear Medicine, CHU de Nantes, 1 place Alexis Ricordeau, 44093, Nantes, France.
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