title: Pre-transplant (18)F-fluorodeoxyglucose positron emission tomography-based survival model in patients with aggressive lymphoma undergoing high-dose chemotherapy and autologous SCT.
abstract: (18)F-fluorodeoxyglucose positron emission tomography (FDG-PET) documented response after salvage chemotherapy has been reported to impact survival in patients with aggressive non-Hodgkin's lymphoma, especially diffuse large B cell lymphoma (DLBCL) undergoing high dose chemotherapy and autologous SCT (HDC auto-SCT). We reviewed the impact of 19 different prognostic/predictive factors before salvage chemotherapy and post-salvage chemotherapy FDG-PET results in patients with aggressive lymphoma and developed an FDG-PET integrated model for post-HDC auto-SCT outcome. The Fine and Gray method for competing risk analysis and a regression model was used to assess the risk associated with different factors on outcome. Fifty-five patients had FDG-PET after salvage chemotherapy; male 65%, female 45%, relapsed 55%, refractory 45%, DLBCL 82%, T cell lymphoma 18%, median age at auto-SCT 40 years, median follow-up 42.4 months. Multivariate analysis identified only positive FDG-PET (P=0.04) and mediastinal involvement (P=0.05) with higher hazard rate of disease-specific death (model P=0.008) but only positive FDG-PET (P=0.01) for disease-specific events (persistent, progressive or relapsed disease). Cumulative incidence of disease-specific death for patients with 0, 1 and 2 risk factors was 5, 30 and 62%, respectively (P=0.01). Our model is significant and showed an increasing risk of failure with mediastinal involvement and post-salvage positive FDG-PET.
authors.affiliation: King Faisal Specialist Hospital and Research Center, Oncology Center, Riyadh, Saudi Arabia. sakhtar@kfshrc.edu.sa
authors.forename: S
authors.initials: S
authors.lastname: Akhtar
authors.forename: A S
authors.initials: AS
authors.lastname: Al-Sugair
authors.forename: M
authors.initials: M
authors.lastname: Abouzied
authors.forename: Y
authors.initials: Y
authors.lastname: Alkadhi
authors.forename: M
authors.initials: M
authors.lastname: Dingle
authors.forename: M
authors.initials: M
authors.lastname: Abdelsalam
authors.forename: H
authors.initials: H
authors.lastname: Soudy
authors.forename: A
authors.initials: A
authors.lastname: Darwish
authors.forename: A
authors.initials: A
authors.lastname: Eltigani
authors.forename: T A M
authors.initials: TA
authors.lastname: Elhassan
authors.forename: M
authors.initials: M
authors.lastname: Nabil-Ahmed
authors.forename: I
authors.initials: I
authors.lastname: Maghfoor
mesh_terms: D000293:Adolescent; D000328:Adult; D018572:Disease-Free Survival; D005260:Female; D019788:Fluorodeoxyglucose F18 / Q000008:administration & dosage*; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D016403:Lymphoma, Large B-Cell, Diffuse / Q000000981:diagnostic imaging / Q000401:mortality / Q000628:therapy; D016399:Lymphoma, T-Cell / Q000000981:diagnostic imaging / Q000401:mortality / Q000628:therapy; D008297:Male; D008954:Models, Biological; D049268:Positron-Emission Tomography; D011859:Radiography; D019275:Radiopharmaceuticals / Q000008:administration & dosage*; D012307:Risk Factors; D016879:Salvage Therapy; D033581:Stem Cell Transplantation; D015996:Survival Rate; D014182:Transplantation, Autologous
chemical_list: D019275:Radiopharmaceuticals; D019788:Fluorodeoxyglucose F18