title: Pretransplantation [18-F]fluorodeoxyglucose positron emission tomography scan predicts outcome in patients with recurrent Hodgkin lymphoma or aggressive non-Hodgkin lymphoma undergoing reduced-intensity conditioning followed by allogeneic stem cell transplantation.
abstract: BACKGROUND
  The use of positron emission tomography (PET) scanning in Hodgkin lymphoma (HL) and aggressive non-Hodgkin lymphoma (HG-NHL) has recognized prognostic value in patients who are receiving chemotherapy or undergoing autologous stem cell transplantation (SCT). In contrast, the role of PET before reduced-intensity conditioning (RIC) and followed by allogeneic SCT has not been investigated to date.
  
  
  METHODS
  PET was used to assess 80 patients who had chemosensitive disease (34 patients with HG-NHL and 46 patients with HL) before they underwent allogeneic SCT: 42 patients had negative PET studies, and 38 patients had positive PET studies. Patients underwent allograft from matched related siblings (n=41) or alternative donors (n=39).
  
  
  RESULTS
  At the time of the last follow-up, 48 patients were alive (60%), and 32 had died. The 3-year cumulative incidence of nonrecurrence mortality and disease recurrence was 17% and 40%, respectively. The cumulative incidence of disease recurrence was significantly lower in the PET-negative patients (25% vs 56%; P=.007), but there was no significant difference between the patients with or without chronic graft-versus-host disease (P=.400). The patients who had negative PET studies before undergoing allogenic SCT also had significantly better outcomes in terms of 3-year overall survival (76% vs 33%; P=.001) and 3-year progression-free survival (73% vs 31%; P=.001). On multivariate analysis, overall survival was influenced by PET status (hazard ratio [HR], 3.35), performance status (HR, 5.15), and type of donor (HR, 6.26 for haploidentical vs sibling; HR, 1.94 for matched unrelated donor vs sibling).
  
  
  CONCLUSIONS
  The current results indicated that PET scanning appears to be an accurate tool for assessing prognosis in patients who are eligible for RIC allografting.
authors.affiliation: Division of Hematology and Bone Marrow Transplantation, Scientific Institute for Hospitalization and Treatment, Istituto Nazionale dei Tumori, Milan, Italy. anna.dodero@istitutotumori.mi.it
authors.forename: Anna
authors.initials: A
authors.lastname: Dodero
authors.forename: Roberto
authors.initials: R
authors.lastname: Crocchiolo
authors.forename: Francesca
authors.initials: F
authors.lastname: Patriarca
authors.forename: Rosalba
authors.initials: R
authors.lastname: Miceli
authors.forename: Luca
authors.initials: L
authors.lastname: Castagna
authors.forename: Fabio
authors.initials: F
authors.lastname: Ciceri
authors.forename: Stefania
authors.initials: S
authors.lastname: Bramanti
authors.forename: Niccolo
authors.initials: N
authors.lastname: Frungillo
authors.forename: Raffaella
authors.initials: R
authors.lastname: Milani
authors.forename: Flavio
authors.initials: F
authors.lastname: Crippa
authors.forename: Federico
authors.initials: F
authors.lastname: Fallanca
authors.forename: Emanuela
authors.initials: E
authors.lastname: Englaro
authors.forename: Paolo
authors.initials: P
authors.lastname: Corradini
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D005260:Female; D019788:Fluorodeoxyglucose F18; D006086:Graft vs Host Disease / Q000453:epidemiology; D006801:Humans; D008228:Lymphoma, Non-Hodgkin / Q000175:diagnosis* / Q000401:mortality / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D049268:Positron-Emission Tomography / Q000379:methods*; D011379:Prognosis; D012008:Recurrence; D012189:Retrospective Studies; D033581:Stem Cell Transplantation; D018183:Transplantation Chimera; D019172:Transplantation Conditioning / Q000379:methods*; D014184:Transplantation, Homologous; D016896:Treatment Outcome
chemical_list: D019788:Fluorodeoxyglucose F18