title: Pretransplant positive positron emission tomography/gallium scans predict poor outcome in patients with recurrent/refractory Hodgkin lymphoma.
abstract: BACKGROUND
  The objective was to determine the prognostic value of functional imaging (FI) in predicting outcome of patients with recurrent/refractory Hodgkin lymphoma (HL) before undergoing high-dose chemotherapy with autologous stem cell transplantation (ASCT).
  
  
  METHODS
  Clinical and imaging data were retrospectively reviewed in 211 consecutive patients treated with ASCT from February 1993 to May 2004. The FI results were correlated with progression-free survival (PFS) and overall survival (OS) using Kaplan-Meier survival analysis.
  
  
  RESULTS
  Responses were assessed by conventional criteria and evaluated by positron emission tomography (PET) (n = 68) and gallium scans (n = 144) before ASCT. A complete response (CR) or unconfirmed CR (CRu) was seen in 51% of patients, a partial response (PR) in 41% of patients, and stable or progressive disease in 7% of patients. FI was positive in only 6 of 110 (5%) of CR/CRu patients, in 48 of 86 (56%) of PR patients, and in all 3 patients with progressive disease. The 3-year PFS was 69% for patients with negative FI versus 23% for patients with positive FI (P < .0001). The 3-year OS rates were 87% and 58%, respectively (P < .0001). The 3-year PFS for patients in PR with negative FI was 51% comparable to patients in CR (76%) versus 27% for patients in PR with positive FI (P < .0001). In a multivariate model, positive FI was found to be independently prognostic of PFS.
  
  
  CONCLUSIONS
  Pretransplant FI status predicts outcome in patients with recurrent/refractory HL. Positive FI confers a poor prognosis, independent of other traditional presalvage prognostic factors.
authors.affiliation: Department of Stem Cell Transplantation and Cellular Therapy, The University of Texas M. D. Anderson Cancer Center, Houston, Texas 77030, USA.
authors.forename: Elias
authors.initials: E
authors.lastname: Jabbour
authors.forename: Chitra
authors.initials: C
authors.lastname: Hosing
authors.forename: Gregory
authors.initials: G
authors.lastname: Ayers
authors.forename: Rodolfo
authors.initials: R
authors.lastname: Nunez
authors.forename: Paolo
authors.initials: P
authors.lastname: Anderlini
authors.forename: Barbara
authors.initials: B
authors.lastname: Pro
authors.forename: Issa
authors.initials: I
authors.lastname: Khouri
authors.forename: Anas
authors.initials: A
authors.lastname: Younes
authors.forename: Fredrick
authors.initials: F
authors.lastname: Hagemeister
authors.forename: Larry
authors.initials: L
authors.lastname: Kwak
authors.forename: Luis
authors.initials: L
authors.lastname: Fayad
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D002648:Child; D003131:Combined Modality Therapy; D005260:Female; D019788:Fluorodeoxyglucose F18; D005710:Gallium Radioisotopes; D018380:Hematopoietic Stem Cell Transplantation; D006689:Hodgkin Disease / Q000000981:diagnostic imaging* / Q000628:therapy; D006801:Humans; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000000981:diagnostic imaging* / Q000628:therapy; D049268:Positron-Emission Tomography; D011379:Prognosis; D019275:Radiopharmaceuticals; D012189:Retrospective Studies; D016879:Salvage Therapy; D015996:Survival Rate; D016896:Treatment Outcome
chemical_list: D005710:Gallium Radioisotopes; D019275:Radiopharmaceuticals; D019788:Fluorodeoxyglucose F18