title: Prognostic significance of FDG-PET in relapsed or refractory classical Hodgkin lymphoma treated with standard salvage chemotherapy and autologous stem cell transplantation.
abstract: Positron emission tomography using [(18)F]fluorodeoxyglucose (FDG-PET) has emerged as the standard response assessment tool in frontline therapy for classical Hodgkin lymphoma (cHL). The ability of FDG-PET to predict outcomes in patients with relapsed cHL treated with modern standard salvage chemotherapy and autologous stem cell transplantation (ASCT) remains uncertain. Forty-six patients with relapsed/refractory cHL treated from 2001 to 2007 with standard salvage/ASCT therapy had FDG-PET available for blinded review. The results of pre-ASCT FDG-PET interpreted by the international harmonization project (IHP) criteria were compared with published prognostic models for prediction of event-free survival (EFS) and overall survival (OS). Overall, 3-year EFS was 62% and OS was 78%, with a median follow-up of 38 months. Pre-ASCT FDG-PET response significantly predicted 3-year EFS in FDG-PET-negative (82%) versus FDG-PET-positive (41%) patients (P = .02). A trend was observed for 3-year OS comparing FDG-PET-negative (91%) versus -positive (64%) patients (P = .08). Multivariate analysis demonstrated the independent prognostic significance of pre-ASCT FDG-PET for EFS with a hazard ratio (HR) of 3.2 (confidence interval [CI] 1.1-9.0, P = .03). Pre-ASCT FDG-PET scans predict EFS in patients with relapsed cHL patients treated with modern salvage/ASCT therapy and warrant prospective evaluation.
authors: Division of Oncology, Section of Bone Marrow Transplantation and Leukemia, Department of Internal Medicine, Washington University School of Medicine, 660 South Euclid Avenue, St. Louis, MO 63110, USA.
authors: Jacob P
authors: JP
authors: Smeltzer
authors: Amanda F
authors: AF
authors: Cashen
authors: Qin
authors: Q
authors: Zhang
authors: Andrew
authors: A
authors: Homb
authors: Farrokh
authors: F
authors: Dehdashti
authors: Camille N
authors: CN
authors: Abboud
authors: John F
authors: JF
authors: Dipersio
authors: Keith E
authors: KE
authors: Stockerl-Goldstein
authors: Geoffrey L
authors: GL
authors: Uy
authors: Ravi
authors: R
authors: Vij
authors: Peter
authors: P
authors: Westervelt
authors: Nancy L
authors: NL
authors: Bartlett
authors: Todd A
authors: TA
authors: Fehniger
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