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.
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.
Dodero
Anna
A
Division of Hematology and Bone Marrow Transplantation, Scientific Institute for Hospitalization and Treatment, Istituto Nazionale dei Tumori, Milan, Italy. anna.dodero@istitutotumori.mi.it
Crocchiolo
Roberto
R
Patriarca
Francesca
F
Miceli
Rosalba
R
Castagna
Luca
L
Ciceri
Fabio
F
Bramanti
Stefania
S
Frungillo
Niccolo
N
Milani
Raffaella
R
Crippa
Flavio
F
Fallanca
Federico
F
Englaro
Emanuela
E
Corradini
Paolo
P
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
D019788:Fluorodeoxyglucose F18