title: Post-treatment (not interim) positron emission tomography-computed tomography scan status is highly predictive of outcome in mantle cell lymphoma patients treated with R-HyperCVAD.
abstract: BACKGROUND
  Although convincing data exist regarding the prognostic utility of positron emission tomographic (PET)-computed tomographic (CT) imaging in Hodgkin lymphoma and diffuse large B-cell lymphoma, its prognostic utility both during treatment and immediately after treatment have not been systematically evaluated in a large mantle cell lymphoma (MCL) patient cohort to support its use in clinical practice.
  
  
  METHODS
  The authors conducted a retrospective cohort study to examine the prognostic utility of PET-CT imaging in a uniform MCL patient cohort undergoing dose-intensive chemotherapy (R-HyCVAD) in the frontline setting. The primary study endpoints were progression-free survival (PFS) and overall survival (OS). PET-CT images were centrally reviewed for the purposes of this study using standardized response criteria.
  
  
  RESULTS
  Fifty-three patients with advanced stage MCL with PET-CT data were identified. With median follow-up of 32 months, 3-year PFS and OS estimates were 76% (95% confidence interval [CI], 64%-84%) and 84% (95% CI, 72%-90%), respectively. Interim PET-CT status was not associated with PFS (hazard ratio [HR], 0.9; 95% CI, 0.3-2.7; P = .8) or OS (HR, 0.6; 95% CI, 0.1-2.9; P = .5). Post-treatment PET-CT status was statistically significantly associated with PFS (HR, 5.2; 95% CI, 2.0-13.6; P = .001) and trended toward significant for OS (HR, 2.8; 95% CI, 0.8-9.6; P = .07).
  
  
  CONCLUSIONS
  These data do not support the prognostic utility of PET-CT in pretreatment and interim treatment settings. A positive PET-CT after the completion of therapy identifies a patient subset with an inferior PFS and a trend toward inferior OS.
authors.affiliation: John Theurer Cancer Center, Hackensack University Medical Center, Hackensack, NJ 07601, USA. amato@humed.com
authors.forename: Anthony R
authors.initials: AR
authors.lastname: Mato
authors.forename: Jakub
authors.initials: J
authors.lastname: Svoboda
authors.forename: Tatyana
authors.initials: T
authors.lastname: Feldman
authors.forename: Tania
authors.initials: T
authors.lastname: Zielonka
authors.forename: Harry
authors.initials: H
authors.lastname: Agress
authors.forename: David
authors.initials: D
authors.lastname: Panush
authors.forename: Mitchell
authors.initials: M
authors.lastname: Miller
authors.forename: Patrick
authors.initials: P
authors.lastname: Toth
authors.forename: Paul M
authors.initials: PM
authors.lastname: Lizotte
authors.forename: Sunita
authors.initials: S
authors.lastname: Nasta
authors.forename: Stuart
authors.initials: S
authors.lastname: Goldberg
authors.forename: Emeline
authors.initials: E
authors.lastname: Chong
authors.forename: Steven
authors.initials: S
authors.lastname: Schuster
authors.forename: Andrew L
authors.initials: AL
authors.lastname: Pecora
authors.forename: Andre
authors.initials: A
authors.lastname: Goy
mesh_terms: D000328:Adult; D000368:Aged; D058846:Antibodies, Monoclonal, Murine-Derived / Q000008:administration & dosage*; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D003520:Cyclophosphamide / Q000627:therapeutic use; D003907:Dexamethasone / Q000627:therapeutic use; D018572:Disease-Free Survival; D004317:Doxorubicin / Q000627:therapeutic use; D005260:Female; D006801:Humans; D020522:Lymphoma, Mantle-Cell / Q000175:diagnosis* / Q000188:drug therapy* / Q000401:mortality; D008297:Male; D008875:Middle Aged; D064847:Multimodal Imaging; D049268:Positron-Emission Tomography; D000069283:Rituximab; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D014750:Vincristine / Q000627:therapeutic use
chemical_list: D058846:Antibodies, Monoclonal, Murine-Derived; D000069283:Rituximab; D014750:Vincristine; D003907:Dexamethasone; D004317:Doxorubicin; D003520:Cyclophosphamide