title: Prognostic role of PET scanning before and after reduced-intensity allogeneic stem cell transplantation for lymphoma.
abstract: Allogeneic stem cell transplantation (SCT) is an established therapy for patients with relapsed lymphoma, but the role of positron emission tomography (PET) scanning preallogeneic and postallogeneic SCT is uncertain. We investigated whether pretransplantation PET status predicted outcome after allogeneic SCT and whether PET surveillance after transplantation provided additional information compared with computed tomography (CT) scanning. Eighty consecutive patients with lymphoma who received a reduced-intensity allogeneic SCT were entered onto a prospective trial. PET and CT scans were performed before transplantation and up to 36 months after transplantation. Forty-two patients were PET-positive before transplantation. Pretransplantation PET status had no significant impact on either relapse rate or overall survival. Thirty-four relapses were observed, of which 17 were PET-positive with a normal CT scan at relapse. Donor lymphocyte infusion (DLI) was administered in 26 episodes of relapse and was guided by PET alone in 14 patients. These findings suggest that, in contrast to autologous SCT, pretransplantation PET status is not predictive of relapse and survival after allogeneic SCT for lymphoma. Posttransplantation surveillance by PET detected relapse before CT in half of episodes, often allowing earlier administration of DLI in patients with recurrent lymphoma, and permitted withholding of potentially harmful DLI in those with PET-negative masses on CT scans.
authors.affiliation: Department of Haematology, University College London Cancer Institute, London, UK.
authors.forename: Jonathan R
authors.initials: JR
authors.lastname: Lambert
authors.forename: Jamshed B
authors.initials: JB
authors.lastname: Bomanji
authors.forename: Karl S
authors.initials: KS
authors.lastname: Peggs
authors.forename: Kirsty J
authors.initials: KJ
authors.lastname: Thomson
authors.forename: Ronjon K
authors.initials: RK
authors.lastname: Chakraverty
authors.forename: Adele K
authors.initials: AK
authors.lastname: Fielding
authors.forename: Panagiotis D
authors.initials: PD
authors.lastname: Kottaridis
authors.forename: Michael
authors.initials: M
authors.lastname: Roughton
authors.forename: Emma C
authors.initials: EC
authors.lastname: Morris
authors.forename: Anthony H
authors.initials: AH
authors.lastname: Goldstone
authors.forename: David C
authors.initials: DC
authors.lastname: Linch
authors.forename: Peter J
authors.initials: PJ
authors.lastname: Ell
authors.forename: Stephen
authors.initials: S
authors.lastname: Mackinnon
mesh_terms: D000328:Adult; D000368:Aged; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D019520:Living Donors; D017710:Lymphocyte Transfusion; D008223:Lymphoma / Q000000981:diagnostic imaging / Q000401:mortality / Q000628:therapy; D008297:Male; D008875:Middle Aged; D049268:Positron-Emission Tomography; D011237:Predictive Value of Tests; D011446:Prospective Studies; D012008:Recurrence; D033581:Stem Cell Transplantation; D015996:Survival Rate; D014057:Tomography, X-Ray Computed; D014184:Transplantation, Homologous