FDG PET in response evaluation of bulky masses in paediatric Hodgkin’s lymphoma (HL) patients enrolled in the Italian AIEOP-LH2004 trial

Lopci, Egesta; Mascarin, Maurizio; Piccardo, Arnoldo; Castello, Angelo; Elia, Caterina; Guerra, Luca; Borsatti, Eugenio; Sala, Alessandra; Todesco, Alessandra; Zucchetta, Pietro; Farruggia, Piero; Cistaro, Angelina; Buffardi, Salvatore; Bertolini, Patrizia; Bianchi, Maurizio; Moleti, Maria Luisa; Bunkheila, Feisal; Indolfi, Paolo; Fagioli, Franca; Garaventa, Alberto; Burnelli, Roberta

doi:10.1007/s00259-018-4155-4

Cited by 11 publications

(8 citation statements)

References 33 publications

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“…This could mean that patients with a more recent diagnosis underwent better staging and more appropriate treatment. The use of PET-CT for evaluating response to therapy allows for better identification of residual masses after chemotherapy, while neither CT nor MRI can easily distinguish the fibrotic or vital nature of residual tissues [ 34 ]. The use of this response-adapted strategy allows for a de-escalation of treatment intensity, with a reduced dose of radiotherapy, even in patients initially placed in higher-risk groups.…”

Section: Discussionmentioning

confidence: 99%

Comparison of Hodgkin’s Lymphoma in Children and Adolescents. A Twenty Year Experience with MH’96 and LH2004 AIEOP (Italian Association of Pediatric Hematology and Oncology) Protocols

Burnelli

Fiumana

Rondelli

et al. 2020

Cancers

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Adolescents and young adults (AYAs) represent a distinct group of patients. The objectives of this study were: To compare adolescent prognosis to that of younger children; to compare the results achieved with the two consecutive protocols in both age groups; to analyze clinical characteristics of children and adolescents. Between 1996 and 2017, 1759 patients aged <18 years were evaluable for the study. Five hundred and sixty patients were treated with the MH’96 protocol and 1199 with the LH2004 protocol. Four hundred and eighty-two were adolescents aged ≥15 years. Patients in both age groups showed very favorable prognoses. In particular, OS improved with the LH2004 protocol, especially in the adolescent group and in the low risk group, where radiation therapy was spared. Adolescent characteristics differed significantly from the children’s according to sex, histology, and the presence of symptoms. Remarkable is the decrease both in mixed cellularity in the children and in low stages in both age groups in the LH2004 protocol with respect to MH’96 protocol. Based on our experience, adopting pediatric protocols for AYA does not compromise patient outcomes.

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Section: Discussionmentioning

confidence: 99%

Comparison of Hodgkin’s Lymphoma in Children and Adolescents. A Twenty Year Experience with MH’96 and LH2004 AIEOP (Italian Association of Pediatric Hematology and Oncology) Protocols

Burnelli

Fiumana

Rondelli

et al. 2020

Cancers

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“…18 F-FDG-PET/CT has been formally incorporated into the standard initial staging, interim response evaluation, and residual disease evaluation at the end of treatment for both adult and pediatric patients with HL [23][24][25] . PET/CT-based, response-adapted treatment has been proven to improve survival and reduce the risk of long-term toxicity in pediatric HL patients 5 .…”

Section: Discussionmentioning

confidence: 99%

Predictive value of interim and post-treatment PET/CT for clinical evaluation in pediatric and adolescent Hodgkin lymphoma: A comparison of the Deauville Criteria and the International Harmonization Project Criteria

Mao

Wang

et al. 2020

Preprint

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Background. The criteria for response evaluation in pediatric and adolescent Hodgkin lymphoma (HL) are controversial. We compared different criteria for the interpretation of interim and post-treatment PET/CT to predict the outcome of pediatric and adolescent HL. Procedure. Baseline, interim, and post-treatment 18F-FDG-PET/CT scans of 147 pediatric and adolescent HL patients were interpreted according to the International Harmonization Project Criteria (IHPC) and Deauville Criteria (DC). Two thresholds of positivity were used for the DC: DC-3, scores of 3-5; and DC-4, scores of 4-5. Diagnostic performance of interim and post-treatment PET in outcome prediction was evaluated. Progression-free survival (PFS) was analyzed by the Kaplan-Meier method and Cox proportional hazards model. Results. Sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and accuracy of interim FDG-PET/CT were 82%,

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“…17-19 However, newer evidence is emerging in the pediatric population whereby response to PET scan is being considered an independent predictive factor. 20 Our analysis is the first from our part of the world in which a PET scan was performed for response evaluation, to our knowledge.…”

Section: Discussionmentioning

confidence: 99%

Outcomes of Refractory and Relapsed Hodgkin Lymphoma With Autologous Stem-Cell Transplantation: A Single Institution Experience

Wali

Saeed

Patrus

et al. 2019

JGO

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PURPOSE Hodgkin lymphoma is the most common cancer in children, adolescents, and young adults. Overall survival is approximately 80% to 90%. A subset of these patients has refractory disease or experience disease relapse. Conventional salvage therapies and autologous stem-cell transplantation is usually considered the standard of care for these patients. Our analysis reports outcomes in these patients. PATIENTS AND METHODS After institutional review board approval, a retrospective analysis of patients with Hodgkin lymphoma who were up to 18 years of age and who had refractory or relapsed disease at Shaukat Khanum Memorial Cancer Hospital and Research Centre from September 2009 to December 2013 was performed. Patients who underwent high-dose chemotherapy followed by stem-cell rescue were included in this analysis. RESULTS A total of 567 patients with Hodgkin lymphoma registered at the hospital. Sixty of the patients (10.6%) had either primary progressive or refractory disease or relapse after finishing with first-line chemotherapy. High-dose chemotherapy followed by stem cell was administered to 25 of these patients (42%). Thirteen patients (40%) had progressive disease (PD), five (22%) had early relapse, and seven (38%) had late relapse. A number of salvage regimens were used, including etoposide, prednisolone, ifosfamide, and cisplatin; dexamethasone, cytarabine, and carboplatin; and gemcitabine plus vinorelbine. Re-evaluation was performed before taking patients to a high dose, and it showed complete response in 17 patients (68%), partial response in six patients (24%), and PD in two patients (8%). Twenty-one patients (84%) are in remission after transplantation, with two patients (8%) having died as a result of disease progression and two patients (2%) having relapsed after treatment. Overall survival is 92% at 4 years, with event-free survival of 80% at 4 years. CONCLUSION Our retrospective analysis shows good outcomes in patients who had PD or refractory disease. Disease response before transplantation is important in predicting outcomes.

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FDG PET in response evaluation of bulky masses in paediatric Hodgkin’s lymphoma (HL) patients enrolled in the Italian AIEOP-LH2004 trial

Cited by 11 publications

References 33 publications

Comparison of Hodgkin’s Lymphoma in Children and Adolescents. A Twenty Year Experience with MH’96 and LH2004 AIEOP (Italian Association of Pediatric Hematology and Oncology) Protocols

Comparison of Hodgkin’s Lymphoma in Children and Adolescents. A Twenty Year Experience with MH’96 and LH2004 AIEOP (Italian Association of Pediatric Hematology and Oncology) Protocols

Predictive value of interim and post-treatment PET/CT for clinical evaluation in pediatric and adolescent Hodgkin lymphoma: A comparison of the Deauville Criteria and the International Harmonization Project Criteria

Outcomes of Refractory and Relapsed Hodgkin Lymphoma With Autologous Stem-Cell Transplantation: A Single Institution Experience

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