Routine blood investigations have limited utility in surveillance of aggressive lymphoma in asymptomatic patients in complete remission

Hawkes, Eliza A; Loh, Zoë; Estacio, Ortis; Chong, Geoffrey; Ha, Francis J.; Gilbertson, Michael; Grigg, Andrew

doi:10.1038/s41416-018-0183-x

Cited by 11 publications

(8 citation statements)

References 26 publications

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“…Another practice of limited evidence in detecting relapse is the performance of regular blood testing in the surveillance of DLBCL [20]. Recently, Hawkes and cols have shown that blood tests do not reliably detect relapse in asymptomatic patients with aggressive lymphoma in CR [21]. In our study, we only detected one patient in which relapse was suspected by abnormal blood test either with physical examination abnormality.…”

Section: Discussionmentioning

confidence: 71%

Evaluation of routine CT scans in the follow-up of diffuse large B-cell lymphomas

et al. 2021

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Objective: Our aim was to retrospectively assess the role of routine CT scans within the first year of follow-up with a limited surveillance policy prior to Lugano recommendations in diffuse large B-cell lymphomas (DLBCL) achieving complete metabolic remission (CMR). We also evaluated the type of relapse detection and exposure to CT scans within the first five years. Methods: Patients diagnosed with DLBCL who achieved CMR after first-line immunochemotherapy were included. Imaging studies and medical records were thoroughly reviewed. Results: Among 101 DLBCL patients in the first CMR, a total of 19 relapses were identified in the study period (18.8% of DLBCL patients included). Nine patients relapsed within the first year (47.4% of all relapses) but only 3 of them were detected by the 202 surveillance CT scans performed during this first year of follow-up. Conclusions: Our real-world data provide clinically applicable results which are in agreement with the Lugano recommendations based on trial data, highlighting the lack of utility of routine CTs in DLBCL patients achieving CMR.

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Section: Discussionmentioning

confidence: 71%

Evaluation of routine CT scans in the follow-up of diffuse large B-cell lymphomas

et al. 2021

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“…This result was in line with that of a previous study of aggressive lymphoma in which routine blood tests did not reliably detect relapse in asymptomatic patients (only 5% of relapse cases were detected) and had no impact on survival. 27 These results suggest that routine blood tests, similar to routine surveillance CT, may have limited value in the detection of lymphoma relapse.…”

Section: Discussionmentioning

confidence: 96%

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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“…Blood routine test contributes to controlling the occurrence and changes of diseases in the body in time (Hawkes et al. 2018 ). D -Xylose, a kind of pentose, is absorbed in the small intestine after oral administration, which reflects the absorption function of the small intestine (Rubino et al.…”

Section: Discussionmentioning

confidence: 99%

Comparative study on the gastrointestinal- and immune- regulation functions of Hedysari Radix Praeparata Cum Melle and Astragali Radix Praeparata cum Melle in rats with spleen-qi deficiency, based on fuzzy matter-element analysis

Zhang

et al. 2022

Pharmaceutical Biology

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Context Hedysari Radix Praeparata Cum Melle (HRPCM) and Astragali Radix Praeparata Cum Melle (ARPCM) are used interchangeably in clinics to treat spleen-qi deficiency (SQD) symptom mainly including gastrointestinal dysfunction and decreased immunity, which has unknown differences in efficacy. Objective To investigate the differences between HRPCM and ARPCM on intervening gastrointestinal- and immune-function with SQD syndrome. Materials and methods After the SQD model was established, the Sprague–Dawley (SD) rats were randomly divided into nine groups ( n = 10): normal; model; Bu-Zhong-Yi-Qi Pills; 18.9, 12.6 and 6.3 g/kg dose groups of HRPCM and ARPCM. Gastrointestinal function including d -xylose, gastrin, amylase vasoactive intestinal peptide, motilin, pepsin, H + /K + -ATPase, Na + /K + -ATPase, sodium-glucose cotransporter 1 (SGLT1), glucose transporter 2 (GLUT2) and immune function including spleen and thymus index, blood routine, interleukin (IL)-2, IL-6, interferon-γ (IFN-γ), tumour necrosis factor-α (TNF-α), immunoglobulin (Ig) M, IgA, IgG and delayed-type hypersensitivity (DTH) were detected. Finally, the efficacy differences were analysed comprehensively by the fuzzy matter-element method. Results In regulating immune, the doses differences in efficacy between HRPCM and ARPCM showed in the high-dose (18.9 g/kg), but there were no differences in the middle- and low- dose (12.6 and 6.37 g/kg); the efficacy differences were primarily reflected in levels of IL-6, IFN-γ, TNF-α and IgM in serum, and the mRNA expression of IL-6 and IFN-γ in the spleen. In regulating gastrointestinal, the efficacy differences were primarily reflected in the levels of D -xylose, MTL, and GAS in serum, and the mRNA and protein expression of SGLT1 and GLUT2 in jejunum and ileum. Discussion and conclusions HRPCM is more effective than ARPCM on regulating gastrointestinal function and immune function with SQD syndrome. Therefore, we propose that HRPCM should be mainly used to treat SQD syndrome in the future.

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Routine blood investigations have limited utility in surveillance of aggressive lymphoma in asymptomatic patients in complete remission

Abstract: Routine blood tests demonstrate unacceptably poor performance characteristics, have no impact on survival and thus have limited value in the detection of relapse in routine surveillance.

Cited by 11 publications

References 26 publications

Evaluation of routine CT scans in the follow-up of diffuse large B-cell lymphomas

Evaluation of routine CT scans in the follow-up of diffuse large B-cell lymphomas

The role of surveillance computed tomography in patients with follicular lymphoma

Comparative study on the gastrointestinal- and immune- regulation functions of Hedysari Radix Praeparata Cum Melle and Astragali Radix Praeparata cum Melle in rats with spleen-qi deficiency, based on fuzzy matter-element analysis

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