Prognostic value of FDG-PET scan imaging in lymphoma patients undergoing autologous stem cell transplantation

Abstract

We conducted a retrospective analysis of 50 lymphoma patients (Hodgkin's disease and non-Hodgkin's lymphoma) who had an 18 F-fluoro-deoxyglucose positron emission tomography (FDG-PET) scan after at least two cycles of salvage chemotherapy and before autologous stem cell transplantation (ASCT) at our institution. The patients were categorized into FDG-PET negative (N ¼ 32) and positive (N ¼ 18) groups. The median follow-up after ASCT was 19 months (range: 3-59). In the FDG-PET-negative group, the median progressionfree survival (PFS) was 19 months (range: 2-59) with 15 (54%) patients without progression at 12 months after ASCT. The median overall survival (OS) for this group was not reached. In the FDG-PET-positive group, the median PFS was 5 months (range: 1-19) with only one (7%) patient without progression at 12 months after ASCT. The median OS was 19 months (range: 1-34). In the FDG-PET-negative group, chemotherapy-resistant patients by CT-based criteria had a comparable outcome to those with chemotherapy-sensitive disease. A positive FDG-PET scan after salvage chemotherapy and prior ASCT indicates an extremely poor chance of durable response after ASCT.

The impact of pre‐ and post‐transplantation positron emission tomography using 18‐fluorodeoxyglucose on poor‐prognosis lymphoma patients undergoing autologous stem cell transplantation

“…In addition, our data confirmed that PET status is correlated strongly with patient prognosis. Recently, as reported by Svoboda et al, 33 it was observed that a positive PET result before ASCT indicated a poor chance of achieving a durable response. In other words, an accurate evaluation of the response to salvage chemotherapy is highly predictive of outcome after ASCT.…”

Role of 18FDG-PET/CT in detecting relapse during follow-up of patients with Hodgkin’s lymphoma

“…More recently, some studies indicated that 18 FDG-FDG-PET also provides useful information about disease status before ASCT and even allogeneic stem cell transplantation in relapsed or refractory HL and non-Hodgkin's lymphoma, with a significant correlation between pretransplant PET status and prognosis [20][21][22][23][24][25][26]. CT scan is the most used in restaging lymphoma; however, some authors reported that history and physical examination could be the standard approach to follow-up because in most cases early recurrence is first suspected by the patient himself or by the physician, even with routine screening including CT scans [27,28].…”

Positron emission tomography using F-18 fluorodeoxyglucose pre- and post-autologous stem cell transplant in non-Hodgkin's lymphoma

“…In a recent retrospective review by Svoboda et al 12 , the charts of 50 patients were analyzed who had undergone FDG PET scanning after at least two cycles of salvage chemotherapy, but prior to ASCT. Of the 50 patients, 31 had NHL, including aggressive and indolent subtypes, and 19 patients had HD.…”