Pre-transplant positron emission tomography in patients with relapsed Hodgkin lymphoma

Móciková, Heidi; Pytlik, Robert; Marková, Jana; Steinerová, Kateřina; Král, Zdeněk; Belada, David; Trnková, M; Trněný, Marek; Koza, Vladimír; Mayer, Jiřı́; Зак, Павел; Kozák, Tomáš

doi:10.3109/10428194.2011.573889

Cited by 59 publications

(45 citation statements)

References 26 publications

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“…Our findings are in accordance with those in previously reported series. 15,16 In a recent study conducted by Mocikova et al, 16 in which 76 patients with relapsed HL were investigated, PET negativity before ASCT was associated with significantly better 2-year rates of progression-free survival (72.7±6.3% versus 36.1±11.6%, P=0.01) and overall survival (90.3±4.1% versus 61.4±11.6%, P=0.009). Other factors were not significant.…”

Section: Discussionmentioning

confidence: 99%

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Positron emission tomography response at the time of autologous stem cell transplantation predicts outcome of patients with relapsed and/or refractory Hodgkin's lymphoma responding to prior salvage therapy

Devillier¹,

Coso²,

Castagna³

et al. 2012

Haematologica

108

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The online version of this article has a Supplementary Appendix. BackgroundHigh-dose chemotherapy followed by autologous stem cell transplantation is the standard treatment for relapsed and/or refractory Hodgkin's lymphoma although half of patients relapse after transplantation. Predictive factors, such as relapse within 12 months, Ann-Arbor stage at relapse, and relapse in previously irradiated fields are classically used to identify patients with poor outcome. Recently, 18-fluorodeoxyglucose positron emission tomography has emerged as a new method for providing information to predict outcome. The aim of this study was to confirm the predictive value of positron emission tomography status after salvage therapy and to compare single versus tandem autologous stem cell transplantation in patients with relapsed and/or refractory Hodgkin's lymphoma. Design and MethodsWe report a series of 111 consecutive patients with treatment-sensitive relapsed and/or treatmentrefractory Hodgkin's lymphoma who achieved complete (positron emission tomography-negative group) or partial remission (positron emission tomography-positive group) at positron emission tomography evaluation after salvage chemotherapy and who underwent single or tandem autologous stem cell transplantation. ResultsFive-year overall and progression-free survival rates were 81% and 64%, respectively. There were significant differences in 5-year progression-free survival (79% versus 23%; P<0.001) and 5-year overall survival (90% versus 55%, P=0.001) between the positron emission tomography-negative and -positive groups, respectively. A complete response, as determined by positron emission tomography evaluation, after salvage therapy predicted significantly better 5-year overall survival rates in both intermediate (91% versus 50%; P=0.029) and unfavorable (89% versus 58%; P=0.026) risk subgroup analyses. In the positron emission tomography-positive subgroup, tandem transplantation improved 5-year progression-free survival from 0% (in the single transplantation group) to 43% (P=0.034). Multivariate analysis showed that positron emission tomography status (hazard ratio: 5.26 [2.57-10.73 ConclusionsIn patients with relapsed/refractory Hodgkin's lymphoma responding to prior salvage therapy, positron emission tomography response at time of autologous stem cell transplantation favorably influences outcome and enables identification of patients requiring single or tandem transplantation.Key words: Hodgkin's lymphoma, PET, outcome, relapsed refractory, ASCT.Citation: Devillier R, Coso D, Castagna L, Brenot Rossi I, Anastasia A, Chiti A, Ivanov V, Schiano JM, Santoro A, Chabannon C, Balzarotti M, Blaise D, and Bouabdallah R. Positron ABSTRACT© F e r r a t a S t o r t i F o u n d a t i o n

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Section: Discussionmentioning

confidence: 99%

“…15,16 We here report a series of patients with relapsed and/or refractory HL who underwent single or tandem ASCT after FDG-PET response assessment.…”

Section: Introductionmentioning

confidence: 99%

Positron emission tomography response at the time of autologous stem cell transplantation predicts outcome of patients with relapsed and/or refractory Hodgkin's lymphoma responding to prior salvage therapy

Devillier¹,

Coso²,

Castagna³

et al. 2012

Haematologica

108

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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%

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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“…Considering the common finding of persistent masses on CT scan, the assessment of response and, consequently, the disease status, often represent a problem among patients diagnosed with HL due to the difficulties in distinguishing fibrotic tissue from active disease (31). In addition to PET scan, which is a technique based on tumor metabolic rate to distinguish fibrotic tissue from residual masses (32,33), gallium scan has been successfully used for several years for this purpose in patients with HL following standard chemotherapy and prior to autologous hematopoietic transplantation (34,35).…”

Section: Discussionmentioning

confidence: 99%

Clinical pretreatment risk factors and prediction of outcome using gallium 67 scintigraphy in patients with Hodgkin's lymphoma

Escobar

López

Rubio

et al. 2015

Molecular and Clinical Oncology

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Abstract. This study was conducted to investigate the prognostic effect and implications of gallium 67 scintigraphy (gallium scan) at mid-treatment and at the end of first-line treatment in patients with early-and advanced-stage Hodgkin's lymphoma (HL). A total of 216 HL patients were included in the study. Gallium scan was performed at mid-treatment and at the end of first-line treatment. The overall survival (OS) and event-free survival (EFS) were calculated using the Kaplan-Meier method. gallium scan results at mid-treatment and at the end of treatment (negative vs. positive, 84 vs. 18%, P<0.001; and 84 vs. 0%, P<0.001, respectively) significantly affected the EFS, whereas age at diagnosis (<50 vs. ≥50 years, 92 vs. 78%, respectively; P=0.04), Hassenclever index (1-3 vs. 4-6, 86 vs. 61%, respectively; P=0.04) and gallium scan results at mid-treatment and at the end of treatment (negative vs. positive, 98 vs. 40%, P<0.001; and 97 vs. 23%, P<0.001, respectively) significantly affected the OS. On the multivariate analysis, gallium scan at the end of first-line treatment retained statistical significance in terms of EFS and OS. In conclusion, post-chemotherapy gallium scan is an important prognostic factor in patients with early-or advanced-stage HL and a predictor of adverse outcome.

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Pre-transplant positron emission tomography in patients with relapsed Hodgkin lymphoma

Cited by 59 publications

References 26 publications

Positron emission tomography response at the time of autologous stem cell transplantation predicts outcome of patients with relapsed and/or refractory Hodgkin's lymphoma responding to prior salvage therapy

Positron emission tomography response at the time of autologous stem cell transplantation predicts outcome of patients with relapsed and/or refractory Hodgkin's lymphoma responding to prior salvage therapy

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

Clinical pretreatment risk factors and prediction of outcome using gallium 67 scintigraphy in patients with Hodgkin's lymphoma

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