title: Association of pre-transplantation positron emission tomography/computed tomography and outcome in mantle cell lymphoma.
abstract: Positron emission tomography/computed tomography (PET/CT)-positive findings before autologous SCT (auto-SCT) are associated with inferior PFS and OS in patients with relapsed Hodgkin's and diffuse large B-cell lymphoma. We classified pre-transplant PET/CT performed before auto-SCT as positive or negative to evaluate the impact of pre-transplant PET/CT in mantle cell lymphoma (MCL). In 29 patients, 17 were PET/CT(-) and 12 were PET/CT(+). PET/CT(+) patients were younger (P=0.04), had lower MCL International Prognostic Index (MIPI, P=0.04) scores, but increased bulky adenopathy >5 cm (45% vs 13%, P=0.09). With a median follow-up of 27 months (range: 5-55 months), 7 patients relapsed (4 in the PET/CT(-) group and 3 in the PET/CT(+) group) with 2 deaths in the PET/CT(+) group without a documented relapse. The estimated 2-year PFS was 64% (95% confidence interval (CI): 0.30-0.85) vs 87% (95% CI: 0.57-0.97) in PET/CT(+) and PET/CT(-) patients, respectively (P=0.054). OS was significantly decreased in PET/CT(+) patients (P=0.007), with 2-year estimates of 60% (95% CI: 0.23-0.84) vs 100% in PET/CT(-) patients. A positive pre-transplant PET/CT is associated with a poor prognosis in patients with MCL. Additional factors may impact the prognostic value of PET/CT, as several PET/CT(+) patients remain in remission.
authors.affiliation: Division of Hematology, Arthur G James Comprehensive Cancer Center and Wexner Medical Center at The Ohio State University, Columbus, OH 43210, USA. jonathon.cohen@osumc.edu
authors.forename: J B
authors.initials: JB
authors.lastname: Cohen
authors.forename: N C
authors.initials: NC
authors.lastname: Hall
authors.forename: A S
authors.initials: AS
authors.lastname: Ruppert
authors.forename: J A
authors.initials: JA
authors.lastname: Jones
authors.forename: P
authors.initials: P
authors.lastname: Porcu
authors.forename: R
authors.initials: R
authors.lastname: Baiocchi
authors.forename: B A
authors.initials: BA
authors.lastname: Christian
authors.forename: S
authors.initials: S
authors.lastname: Penza
authors.forename: D M
authors.initials: DM
authors.lastname: Benson
authors.forename: J
authors.initials: J
authors.lastname: Flynn
authors.forename: L A
authors.initials: LA
authors.lastname: Andritsos
authors.forename: S M
authors.initials: SM
authors.lastname: Devine
authors.forename: K A
authors.initials: KA
authors.lastname: Blum
mesh_terms: D000328:Adult; D000368:Aged; D018572:Disease-Free Survival; D005260:Female; D018380:Hematopoietic Stem Cell Transplantation / Q000379:methods*; D006801:Humans; D020522:Lymphoma, Mantle-Cell / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D064847:Multimodal Imaging / Q000379:methods*; D049268:Positron-Emission Tomography / Q000379:methods*; D011379:Prognosis; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed / Q000379:methods*; D019172:Transplantation Conditioning / Q000379:methods; D014184:Transplantation, Homologous; D016896:Treatment Outcome