Pretransplant positive positron emission tomography/gallium scans predict poor outcome in patients with recurrent/refractory Hodgkin lymphoma

Jabbour, Elias; Hosing, Chitra; Ayers, Gregory D.; Núñez, Rodolfo; Anderlini, Paolo; Pro, Barbara; Khouri, Issa F.; Younes, Anas; Hagemeister, Fredrick B.; Kwak, Larry W.; Fayad, Luis

doi:10.1002/cncr.22714

Cited by 140 publications

(112 citation statements)

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“…Studies reporting 20 or more HL patients in HDC ASCT setting are limited. [7][8][9][10][11][12][13][14][15]25,26 Many studies have combined various non Hodgkin's lymphoma (NHL) and HL together. Most studies analyzed FDG-PET as an individual risk factor rather than integrating it with all other factors.…”

Section: Discussionmentioning

confidence: 99%

“…[1][2][3][4] There has been increasing use of 18 F-fluorodeoxyglucose positron emission tomography (FDG-PET) scanning for response assessment after salvage chemotherapy or before HDC ASCT in patients with HL. [5][6][7][8][9][10][11][12][13][14][15][16] Patients with FDG-PET-positive disease after salvage chemotherapy or before HDC ASCT have been reported to have inferior outcome. Currently, there is no comprehensive predictive model integrating FDG-PET with other pre-salvage clinical risk factors in this group.…”

Section: Introductionmentioning

confidence: 99%

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Pre-transplant FDG-PET-based survival model in relapsed and refractory Hodgkin’s lymphoma: outcome after high-dose chemotherapy and auto-SCT

Akhtar

Al-Sugair

Abouzied

et al. 2013

Bone Marrow Transplant

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Hodgkin's lymphoma (HL) patients with positive 18 F-fluorodeoxyglucose positron emission tomography (FDG-PET) post salvage chemotherapy or before high-dose chemotherapy and auto-SCT (HDC ASCT) have inferior outcomes. We reviewed 21 prognostic factors before salvage chemotherapy (at relapse/progression) and integrated post salvage FDG-PET results to develop a prognostic model for post HDC ASCT outcome. We used Fine and Gray method for competing risk analysis and regression model for risks assessment and outcome. One hundred and forty-one patients had post salvage FDG-PET before HDC ASCT (median age 25.5 years); male/female 55%:45%, relapsed/refractory 43%:57%, median follow-up 33 months. Multivariate analysis identified HL International Prognostic Score X3 (P ¼ 0.001; hazard ratio (HR): 3.7 (1.6-8.3)) and post salvage positive FDG-PET (P ¼ 0.011; HR: 3.4 (1.3-8.9)) with higher hazard of disease-specific death (model P ¼ 0.0001). Cumulative incidence of disease-specific death with 0, 1, 2 risk factors was 7%:29%:52%, respectively (P ¼ 0.00003). For disease-specific event (persistent, progressive or relapsed disease), mediastinal involvement (P ¼ 0.024; HR: 2.7 (1.14-6.5)), B symptoms (P ¼ 0.027; HR: 2.1 (1.09-4.2)) and positive post salvage FDG-PET (P ¼ 0.001; HR: 3.3 (1.7-6.7)) were significant (model P ¼o0.00001). Cumulative incidence of disease-specific event with 0, 1, 2, 3 risk factors was 8%:31%:50%:75%, respectively (P ¼ 0.0000006). Patients with higher scores have higher risk of treatment failure. They are potential candidates for newer therapies along with HDC ASCT.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Pre-transplant FDG-PET-based survival model in relapsed and refractory Hodgkin’s lymphoma: outcome after high-dose chemotherapy and auto-SCT

Akhtar

Al-Sugair

Abouzied

et al. 2013

Bone Marrow Transplant

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“…It is highly sensitive and specific in HL and in the majority of aggressive lymphoma subtypes, and it is noteworthy that the results are predictive of outcome in patients with recurrent HL or NHL who receive high-dose chemotherapy and undergo autologous SCT. [9][10][11] The objective of the current retrospective study was to assess the prognostic role of FDG-PET in patients with chemosensitive HL or aggressive NHL before RIC alloSCT.…”

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confidence: 99%

Pretransplantation [18‐F]fluorodeoxyglucose positron emission tomography scan predicts outcome in patients with recurrent Hodgkin lymphoma or aggressive non‐Hodgkin lymphoma undergoing reduced‐intensity conditioning followed by allogeneic stem cell transplantation

Dodero

Crocchiolo

Miceli

et al. 2010

Cancer

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BACKGROUND:The use of positron emission tomography (PET) scanning in Hodgkin lymphoma (HL) and aggressive non-Hodgkin lymphoma (HG-NHL) has recognized prognostic value in patients who are receiving chemotherapy or undergoing autologous stem cell transplantation (SCT). In contrast, the role of PET before reduced-intensity conditioning (RIC) and followed by allogeneic SCT has not been investigated to date. METHODS: PET was used to assess 80 patients who had chemosensitive disease (34 patients with HG-NHL and 46 patients with HL) before they underwent allogeneic SCT: 42 patients had negative PET studies, and 38 patients had positive PET studies. Patients underwent allograft from matched related siblings (n ¼ 41) or alternative donors (n ¼ 39). RESULTS: At the time of the last follow-up, 48 patients were alive (60%), and 32 had died. The 3-year cumulative incidence of nonrecurrence mortality and disease recurrence was 17% and 40%, respectively. The cumulative incidence of disease recurrence was significantly lower in the PET-negative patients (25% vs 56%; P ¼ .007), but there was no significant difference between the patients with or without chronic graft-versus-host disease (P ¼ .400). The patients who had negative PET studies before undergoing allogenic SCT also had significantly better outcomes in terms of 3-year overall survival (76% vs 33%; P ¼ .001) and 3-year progression-free survival (73% vs 31%; P ¼ .001). On multivariate analysis, overall survival was influenced by PET status (hazard ratio [HR], 3.35), performance status (HR, 5.15), and type of donor (HR, 6.26 for haploidentical vs sibling; HR, 1.94 for matched unrelated donor vs sibling). CONCLUSIONS: The current results indicated that PET scanning appears to be an accurate tool for assessing prognosis in patients who are eligible for RIC allografting. Cancer 2010;116:5001-11.

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“…Трехлетняя выжива-емость без прогрессирования составила 69 и 23 % для больных с накоплением и без накопления радиофарм-препарата (РФП) в остаточных очагах соответственно. Трехлетняя ОВ составила 87 и 58 % соответственно [61].…”

Section: прогностические системы для предсказания эффективности трансunclassified

Primary Resistant Course and Recurrence of the Hodgkin,s Lymphoma. Preventable Losses at “Most Recoverable” Hemoblastosis

Жуков¹

2015

Ross. ž. det. gematol. onkol.

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Pretransplant positive positron emission tomography/gallium scans predict poor outcome in patients with recurrent/refractory Hodgkin lymphoma

Cited by 140 publications

References 34 publications

Pre-transplant FDG-PET-based survival model in relapsed and refractory Hodgkin’s lymphoma: outcome after high-dose chemotherapy and auto-SCT

Pre-transplant FDG-PET-based survival model in relapsed and refractory Hodgkin’s lymphoma: outcome after high-dose chemotherapy and auto-SCT

Pretransplantation [18‐F]fluorodeoxyglucose positron emission tomography scan predicts outcome in patients with recurrent Hodgkin lymphoma or aggressive non‐Hodgkin lymphoma undergoing reduced‐intensity conditioning followed by allogeneic stem cell transplantation

Primary Resistant Course and Recurrence of the Hodgkin,s Lymphoma. Preventable Losses at “Most Recoverable” Hemoblastosis

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