title: Hodgkin lymphoma patients in first remission: routine positron emission tomography/computerized tomography imaging is not superior to clinical follow-up for patients with no residual mass.
abstract: There is no consensus regarding optimal follow-up mode for Hodgkin lymphoma (HL) patients that achieve complete remission following chemotherapy or combined chemo- and radiation therapy. Several studies demonstrated high sensitivity of positron emission tomography/computerized tomography (PET/CT) in detecting disease progression; however, these techniques are currently not recommended for routine follow-up. This retrospective study conducted in two Israeli (N = 291) and one New Zealand academic centres (N = 77), compared a group of HL patients, followed-up with routine imaging every 6 months during the first 2 years after achieving remission, once in the third year, with additional dedicated studies performed due to symptoms or physical findings (Group I) to a group of patients without residual masses who underwent clinically-based surveillance with dedicated imaging upon relapse suspicion (Group II). Five-year overall survival (OS) was 94% and median time to relapse was 8·6 months for both modes. Relapse rates in Groups I and II were 13% and 9%, respectively. During the first 3 years of follow-up, 47·5 and 4·7 studies were performed per detected relapse in Groups I and II, respectively. The current study demonstrated no benefit in either progression-free survival (PFS) or OS in HL patients followed by routine imaging versus clinical follow-up. The cost was 10 times higher for routine imaging.
authors: Blood Bank and Apheresis Unit, Rambam Health Care Campus, Haifa, Israel; Department of Haematology and Bone Marrow Transplantation, Rambam Health Care Campus, Haifa, Israel; Bruce Rappaport Faculty of Medicine, Technion, Israel Institute of Technology, Haifa, Israel.
authors: Eldad J
authors: EJ
authors: Dann
authors: Leanne
authors: L
authors: Berkahn
authors: Tatiana
authors: T
authors: Mashiach
authors: Michael
authors: M
authors: Frumer
authors: Ariel
authors: A
authors: Agur
authors: Bridgett
authors: B
authors: McDiarmid
authors: Rachel
authors: R
authors: Bar-Shalom
authors: Ora
authors: O
authors: Paltiel
authors: Neta
authors: N
authors: Goldschmidt
mesh_terms: D005260:Female; D005500:Follow-Up Studies; D017048:Health Care Costs / Q000706:statistics & numerical data; D006689:Hodgkin Disease / Q000175:diagnosis* / Q000191:economics / Q000401:mortality / Q000628:therapy; D006801:Humans; D007557:Israel / Q000453:epidemiology; D053208:Kaplan-Meier Estimate; D008134:Long-Term Care / Q000191:economics / Q000379:methods*; D008297:Male; D064847:Multimodal Imaging / Q000191:economics / Q000706:statistics & numerical data; D009367:Neoplasm Staging; D018365:Neoplasm, Residual; D009520:New Zealand / Q000453:epidemiology; D011159:Population Surveillance / Q000379:methods; D049268:Positron-Emission Tomography / Q000191:economics / Q000706:statistics & numerical data; D012008:Recurrence; D012074:Remission Induction; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed / Q000191:economics / Q000706:statistics & numerical data
keywords: Hodgkin lymphoma; clinical follow-up; positron emission tomography/computerized tomography; remission; sensitivity