The role of routine imaging procedures in the detection of relapse of patients with Hodgkin lymphoma and aggressive non-Hodgkin lymphoma.
Despite improved initial therapies, a subgroup of patients with aggressive non-Hodgkin (A-NHL) and Hodgkin lymphomas (HL) will relapse after first remission. The optimal follow-up strategy for the detection of relapse has not been clarified and periodic imaging is not recommended in most written guidelines. We identified 125 patients with HL and A-NHL diagnosed between January 1993 and September 2008 who relapsed at least 1 month after the end of initial therapy. We assessed whether relapse was detected based on clinical signs or periodic computed tomography (CT), [(18)F] fluorodeoxyglucose positron emission tomography (PET), or combined PET/CT and whether the mode of detection influenced the pattern and outcome of relapsed disease. Overall, most relapses (62%) were diagnosed clinically especially in A-NHL and in patients with extranodal involvement at diagnosis (p < 0.05); however, relapses of HL occurring after 2001 when PET/CT became available were more commonly detected by routine imaging (p < 0.05). Imaging-detected relapse was not associated with improved survival. While clinical exam remains the most common mode of detecting relapse, our results suggest a potential role for routine PET/CT surveillance in HL patients; however, survival does not appear to be affected by mode of detection.
Goldschmidt
Neta
N
Department of Hematology, Hadassah-Hebrew University Medical Center, Jerusalem, Israel. neta@hadassah.org.il
Or
Omer
O
Klein
Martine
M
Savitsky
Bella
B
Paltiel
Ora
O
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D019788:Fluorodeoxyglucose F18; D006689:Hodgkin Disease / Q000473:pathology* / Q000517:prevention & control*; D006801:Humans; D008228:Lymphoma, Non-Hodgkin / Q000473:pathology* / Q000517:prevention & control*; D008875:Middle Aged; D049268:Positron-Emission Tomography / Q000379:methods*; D019275:Radiopharmaceuticals; D012008:Recurrence; D012074:Remission Induction; D015996:Survival Rate; D014057:Tomography, X-Ray Computed / Q000379:methods*; D055815:Young Adult
D019275:Radiopharmaceuticals; D019788:Fluorodeoxyglucose F18