Prognostic impact of pretransplantation computed tomography and gallium scans in patients with Hodgkin lymphoma with poor prognosis undergoing hematopoietic stem cell transplantation.
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.
Escobar
Ignacio Garcia
IG
Department of Hematology and Nuclear Medicine, Hospital Clínico Universitario de Salamanca, Spain. naxto@hotmail.com
Barrigon
Dolores Caballero
DC
Tamayo
Pilar
P
Perez-Simon
Jose Antonio
JA
Mateos
Maria Vitoria
MV
Garcia
Jose Ramon
JR
San Miguel
Jesus F
JF
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
D005710:Gallium Radioisotopes