Determining response and recurrence in pediatric B‐cell lymphomas of the bone

Borst, Alexandra J.; States, Lisa J.; Reilly, Anne; Rheingold, Susan R.

doi:10.1002/pbc.24523

Cited by 10 publications

(4 citation statements)

References 26 publications

(56 reference statements)

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“…A growing body of evidence suggests that routine and frequent surveillance imaging does not improve patient care in primary bone lymphomas. MRI is sensitive and carries no radiation exposure, but MRI can remain abnormal for at least 2 years after disease resolution,3 which is the period when relapse is most often seen. By contrast, PET scans are positive at diagnosis in 98% of bone lymphomas,1 and PET scans will show rapid decrease in fluorodeoxyglucose (FDG) activity with treatment response.…”

Section: Discussionmentioning

confidence: 99%

“…Incidental findings were seen in 18% of PET-CTs, 19% of MRIs and 12% of CTs 3. This led the authors to recommend minimal follow-up imaging, using it for symptom evaluation only and not as surveillance.…”

Section: Discussionmentioning

confidence: 99%

“…DLBCL is the most common NHL subtype to arise in bone and has an excellent prognosis, particularly with Murphy stage I or II disease 2. Most studies report a 5-year overall survival of over 90% 3. Relapsed patients are frequently salvaged successfully.…”

Section: Introductionmentioning

confidence: 99%

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Challenges of assessing response to therapy in non-Hodgkin’s lymphoma of the bone

Paul

Kuo²

2018

BMJ Case Reports

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A 17-year-old male adolescent was diagnosed with diffuse large B cell lymphoma arising from the right humeral head. The lymphoma was found to be isolated to the bone, with a very small extraosseous component. After completion of a standard chemotherapy regimen, the Positron Emission Tomography-Computed Tomography (PET-CT) became PET negative but the CT and MRI appeared mostly unchanged in appearance, suggesting refractory disease. Repeat biopsy confirmed that no lymphoma remained, and he was in complete remission. Three months after completion of therapy, MRI continued to be abnormal. This case illustrates the unique challenges posed by the imaging characteristics of bone lymphoma, both during and after therapy. Biopsy is definitive but causes additional morbidity and may not be necessary. Imaging is done routinely to assess response to therapy, as with this patient, but in lymphomas of the bone imaging can be misleading and can lead to unnecessary procedures or follow-up imaging.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Challenges of assessing response to therapy in non-Hodgkin’s lymphoma of the bone

Paul

Kuo²

2018

BMJ Case Reports

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“…Both may be positive in cases of radiographically occult primary bone lymphoma. With treatment, FDG-PET activity decreases, but low-level activity may remain for a year posttherapy [ 77 ].…”

Section: Imagingmentioning

confidence: 98%

Tumors and Tumor-Like Conditions of Bone

Wootton‐Gorges

2014

Pediatric Orthopedic Imaging

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This chapter fi rst discusses general principles of tumor imaging, including both characteristics of benign and malignant tumors and utility of different imaging modalities. It then enters an in-depth discussion of benign tumors and tumor-like lesions, addressing cystic, cartilaginous, osseous, fi bro-osseous, and vascular lesions, along with Langerhans cell histiocytosis. It concludes with a review of osteosarcoma and Ewing sarcoma, the more common malignant tumors, as well as chondrosarcoma, lymphoma, malignant fi brous histiocytoma, and metastatic disease.

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A systematic review of evidence for and against routine surveillance imaging after completing treatment for childhood extracranial solid tumors

et al. 2020

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Background Regular off‐treatment imaging is often used to assess for recurrence of disease after childhood cancer treatment. It is unclear if this increases survival, or what burden surveillance places on patients, families, or health‐care services. This systematic review examines the impact of routine surveillance imaging after treatment of pediatric extracranial solid tumors. Methods Collaborative patient and public involvement informed the design and interpretation of this work. Thirteen electronic databases, conference proceedings, and trial registries were searched alongside reference list checking and forward citation searching from 1990 onwards. Studies were screened and data were extracted by two researchers. Risk of bias was assessed using a modified ROBINS‐I tool. Relevant outcomes were overall survival, psychological distress indicators, number of imaging tests, cost‐effectiveness, and qualitative data regarding experiences of surveillance programs. PROSPERO (CRD42018103764). Results Of 17 727 records identified, 55 studies of 10 207 patients were included. All studies used observational methods. Risk of bias for all except one study was moderate, serious, or critical. Data were too few to conduct meta‐analysis; however, narrative synthesis was performed. Surveillance strategies varied, and poorly reported, involving many scans and substantial radiation exposure (eg, neuroblastoma, median 133.5 mSv). For most diseases, surveillance imaging was not associated with increased overall survival, with the probable exception of Wilms tumor. No qualitative or psychological distress data were identified. Conclusions At present, there is insufficient evidence to evaluate the effects of routine surveillance imaging on survival in most pediatric extracranial solid tumors. More high‐quality data are required, preferably through randomized controlled trials with well‐conducted qualitative elements.

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Determining response and recurrence in pediatric B‐cell lymphomas of the bone

Cited by 10 publications

References 26 publications

Challenges of assessing response to therapy in non-Hodgkin’s lymphoma of the bone

Challenges of assessing response to therapy in non-Hodgkin’s lymphoma of the bone

Tumors and Tumor-Like Conditions of Bone

A systematic review of evidence for and against routine surveillance imaging after completing treatment for childhood extracranial solid tumors

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