title: Prognostic impact of pretransplantation computed tomography and gallium scans in patients with Hodgkin lymphoma with poor prognosis undergoing hematopoietic stem cell transplantation.
abstract: BACKGROUND
  The present study evaluated computed tomography (CT) and Gallium-67 scanning (67Ga) before transplantation as prognostic factors for overall survival (OS) and event-free survival (EFS) in patients with relapsed or primary refractory Hodgkin lymphoma undergoing high-dose chemotherapy and stem cell transplantation.
  
  
  METHODS
  Forty-five patients were included. Of these, 10 (22%) had positive CT and 67Ga scan results, 21 (47%) had negative results of both techniques, 12 (27%) had positive CT/negative 67Ga scan results, and 2 (5%) had negative CT/positive 67Ga scan results.
  
  
  RESULTS
  Patients with positive CT/67Ga scan results had a significantly worse EFS and OS at 5 years than those with negative 67Ga scan results, whether it was associated with positive or negative CT scan results (0 and 25% vs. 83% and 90% vs. 74% and 83%, respectively; P < 0.001). With a median follow-up of 59 months (range, 6-150 months), no differences were observed between patients with negative CT/67Ga scan results and those with positive CT/negative 67Ga scan results, with an EFS and OS at 5 years of 74% vs. 83% and 83% vs. 90%, respectively. In multivariate analysis, the presence of pretransplantation positive CT/67Ga scan results adversely influenced EFS and OS (hazard ratio, 39; 95% confidence interval, 8-202 [P < 0.001] and hazard ratio, 24; 95% confidence interval, 4-135 [P < 0.001], respectively).
  
  
  CONCLUSIONS
  Gallium-67 scans help to identify pretransplantation CT-positive patients with a different outcome. A group of patients with positive CT/negative 67Ga scan results before transplantation who showed a favorable outcome with a low rate of relapse and another group of patients with positive CT/67Ga scan results before transplantation who showed poor prognosis did not benefit from autologous stem cell transplantation. They should be offered other therapeutic strategies.
authors.affiliation: Department of Hematology and Nuclear Medicine, Hospital Clínico Universitario de Salamanca, Spain. naxto@hotmail.com
authors.forename: Ignacio Garcia
authors.initials: IG
authors.lastname: Escobar
authors.forename: Dolores Caballero
authors.initials: DC
authors.lastname: Barrigon
authors.forename: Pilar
authors.initials: P
authors.lastname: Tamayo
authors.forename: Jose Antonio
authors.initials: JA
authors.lastname: Perez-Simon
authors.forename: Maria Vitoria
authors.initials: MV
authors.lastname: Mateos
authors.forename: Jose Ramon
authors.initials: JR
authors.lastname: Garcia
authors.forename: Jesus F
authors.initials: JF
authors.lastname: San Miguel
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001799:Blood Sedimentation; D018572:Disease-Free Survival; D005260:Female; D005710:Gallium Radioisotopes; D018380:Hematopoietic Stem Cell Transplantation / Q000379:methods*; D006689:Hodgkin Disease / Q000000981:diagnostic imaging* / Q000628:therapy*; D006801:Humans; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D011379:Prognosis; D011877:Radionuclide Imaging / Q000379:methods*; D012008:Recurrence; D014057:Tomography, X-Ray Computed / Q000379:methods*; D016896:Treatment Outcome
chemical_list: D005710:Gallium Radioisotopes