Impact of Routine Surveillance Imaging on Outcomes of Patients With Diffuse Large B-Cell Lymphoma After Autologous Hematopoietic Cell Transplantation

Epperla, Narendranath; Shah, Namrata; Hamadani, Mehdi; Richardson, Kristin; Kapke, Jonathan; Patel, Asmita; Teegavarapu, Sravanthi P.; Carrum, George; Hari, Parameswaran; Pingali, Sai Ravi; Karmali, Reem; Fenske, Timothy S.

doi:10.1016/j.clml.2016.08.018

Cited by 7 publications

(3 citation statements)

References 23 publications

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“…There have been several retrospective studies evaluating the role of surveillance scans in lymphomas (Table 1). [8][9][10][11][12][13] However, no clear clinical benefit has been shown.…”

Section: Rationale For Surveillance Imagingmentioning

confidence: 99%

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Surveillance in Patients With Diffuse Large B Cell Lymphoma

Kallam

Adusumalli

Armitage

2020

Mayo Clinic Proceedings

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With improvement in the cure rates for diffuse large B cell lymphoma, the question of surveillance imaging in patients who achieve complete remission after the initial therapy has become relevant. Some of the clinical practice guidelines recommend surveillance scanning. However, several studies have reported no benefit in overall survival with scans. Moreover, studies have highlighted an increased risk for developing secondary malignancies because of exposure to ionizing radiation from the scans. Different international societies have contrasting guidelines for the role of surveillance computerized tomography scans in patients who achieve complete remission after first-line therapy. Any benefit of surveillance imaging must be balanced by the costs, risk of radiation exposure, and lack of survival benefit. The PubMed platform was searched using relevant keywords for English-language articles with no date restrictions. Search terms were cross-referenced with review articles, and additional articles were identified by manually searching reference lists. Results were reviewed by the authors and selected for inclusion based on relevance. We present a review of this current data available for surveillance imaging in patients with diffuse large B cell lymphoma.

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“…There have been several retrospective studies evaluating the role of surveillance scans in lymphomas (Table 1). [8][9][10][11][12][13] However, no clear clinical benefit has been shown.…”

Section: Rationale For Surveillance Imagingmentioning

confidence: 99%

“…Epperla et al 12 conducted a retrospective multicenter study evaluating the role of surveillance imaging on outcomes of patients with DLBCL after auto-HST. One hundred sixty patients with DLBCL who achieved complete remission after auto-HST were evaluated.…”

Section: Article Highlightsmentioning

confidence: 99%

Surveillance in Patients With Diffuse Large B Cell Lymphoma

Kallam

Adusumalli

Armitage

2020

Mayo Clinic Proceedings

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“…However, previous studies of patients with curable lymphoma subtypes, such as diffuse large B-cell lymphoma (DLBCL) and Hodgkin lymphoma (HL), have reported that routine surveillance imaging with CT or positron emission tomography (PET) detects relapse in only few cases; most relapse cases are detected clinically, based on patient-reported symptoms, abnormal physical findings, and blood workup abnormalities. 1 – 10 Moreover, most previous studies have revealed that surveillance imaging offers no survival benefit for patients with curable lymphoma subtypes, mainly DLBCL and HL. 2 , 5 – 7 , 10 , 11 Given the excessive radiation exposure, medical costs, and unclear survival benefit associated with surveillance imaging, the 2014 Lugano classification discouraged its use for curable lymphoma subtypes, and the American Society of Hematology Choosing Wisely Campaign recommended limiting the use of surveillance CT for curable non-Hodgkin lymphoma (NHL).…”

Section: Introductionmentioning

confidence: 99%

The role of surveillance computed tomography in patients with follicular lymphoma

Hatta

Fukuhara²,

Fujino

et al. 2022

Therapeutic Advances in Hematology

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Introduction: Surveillance computed tomography (CT) is performed during the follow-up of patients with lymphoma who have completed initial therapy. However, studies on the clinical benefit of surveillance CT for patients with incurable subtypes, such as follicular lymphoma (FL), are limited. This study aimed to evaluate the value of surveillance CT for patients with FL after achieving the first complete response (CR) or CR unconfirmed in the rituximab era. Methods: We retrospectively reviewed the medical records of patients with FL who achieved CR with first-line treatment between 2000 and 2016 at our institution. In patients who experienced first relapse, we examined the patient’s clinical characteristics at the time of relapse, subsequent therapies, and post-relapse survival, based on the method of relapse detection. Results: Of the 248 patients who achieved CR after initial therapy, 109 had a relapse, with a median follow-up of 11 years; 100 were enrolled into this study. Relapse was detected by surveillance CT in 61 patients (surveillance CT group) and by means other than surveillance CT, such as the presence of patient-reported symptoms, physical findings, and blood work-up abnormalities (non-surveillance CT group), in 39 patients. There was no significant difference in the patients’ characteristics at the time of relapse between the two groups, except for a higher incidence of extranodal involvement in the non-surveillance CT group. The method of relapse detection did not affect therapeutic selection after relapse and post-relapse survival. In this study, 86.8% of the 38 patients who relapsed with only deep lesions, such as mesenteric or retroperitoneal lymph nodes, had surveillance CT-detected relapse. Conclusion: Surveillance CT did not show any clinical benefit for patients with FL in CR; however, it might lead to early detection of relapse in cases of deep lesions that cannot be identified without imaging.

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