对于患有滤泡性淋巴瘤 (FL) 的晚期低肿瘤负荷 (LTB) 患者，观察等待是一种可接受的治疗策略。然而，对这种无治疗观察期将持续多久的预测仍然不完善。我们探讨了总代谢肿瘤体积（TMTV）和其他正电子发射断层扫描参数是否可以预测首次治疗时间（TTFT）。我们分析了 97 名 1-3A 级晚期 LTB FL 患者，发现高 TMTV 与诊断时的其他肿瘤负荷特征相关。 TMTV 高于我们设定的 50 mL 临界值的患者的中位观察时间明显较短（2.6 年与 8.8 年；p = 0.001）。 5 年时，77% TMTV 高的患者和 46% TMTV 低的患者需要治疗。在多变量分析中，高 TMTV 是预测 TTFT 的唯一独立因素（风险比 = 2.09；p = 0.017）。总体而言，TMTV 是 LTB FL 患者观察持续时间的有力预测因子。在验证我们的外部系列截止值和方法标​​准化后，TMTV 可能成为考虑推迟或开始其他 LTB 患者治疗的额外因素。© 2023 作者。约翰·威利 (John Wiley) 出版的《血液肿瘤学》

Watchful waiting is an acceptable management strategy for advanced-stage, low tumor burden (LTB) patients with follicular lymphoma (FL). However, the prediction of how long this treatment-free observation period will last remains imperfect. We explored whether total metabolic tumor volume (TMTV) and other positron emission tomography parameters were predictive of time to first treatment (TTFT). We analyzed 97 grade 1-3A advanced-stage LTB FL patients and found that a high TMTV was associated with other tumor burden features at diagnosis. Patients with a TMTV above our established cutoff of 50 mL had a significantly shorter median duration of observation (2.6 vs. 8.8 years; p = 0.001). At 5 years, 77% of patients with a high TMTV and 46% of patients with a low TMTV required treatment. In the multivariable analysis, a high TMTV was the only independent factor predicting TTFT (hazard ratio = 2.09; p = 0.017). Overall, TMTV is a strong predictor of the duration of observation in LTB FL patients. Upon validation of our cutoff in external series and standardization of the methodology, the TMTV could become an additional factor to consider deferring or initiating treatment in otherwise LTB patients.© 2023 The Authors. Hematological Oncology published by John Wiley & Sons Ltd.