title: F-18 FDG-PET predicts outcomes for patients receiving total lymphoid irradiation and autologous blood stem-cell transplantation for relapsed and refractory Hodgkin lymphoma.
abstract: Total lymphoid irradiation (TLI) followed by high-dose chemotherapy and autologous haematopoietic stem cell transplant (aHSCT) is an effective strategy for patients with relapsed/refractory classical Hodgkin lymphoma (HL). We report outcomes for patients with relapsed/refractory HL who received TLI followed by high-dose chemotherapy and aHSCT. Pre-transplant fludeoxyglucose positron emission tomography (FDG-PET) studies were scored on the 5-point Deauville scale. Of 51 patients treated with TLI and aHSCT, 59% had primary refractory disease and 63% had active disease at aHSCT. The 10-year progression-free survival (PFS) and overall survival (OS) for all patients was 56% and 54%, respectively. Patients with complete response (CR) by PET prior to aHSCT had a 5-year PFS and OS of 85% and 100% compared to 52% and 48% for those without CR (P = 0·09 and P = 0·007, respectively). TLI and aHSCT yields excellent disease control and long-term survival rates for patients with relapsed/refractory HL, including those with high-risk disease features. Achievement of CR with salvage therapy is a powerful predictor of outcome.
authors.affiliation: Division of Hematology/Oncology and the Robert H. Lurie Comprehensive Cancer Center, Northwestern University Feinberg School of Medicine, Chicago, IL, USA.
authors.forename: Ryan D
authors.initials: RD
authors.lastname: Gentzler
authors.forename: Andrew M
authors.initials: AM
authors.lastname: Evens
authors.forename: Alfred W
authors.initials: AW
authors.lastname: Rademaker
authors.forename: Bing B
authors.initials: BB
authors.lastname: Weitner
authors.forename: Bharat B
authors.initials: BB
authors.lastname: Mittal
authors.forename: Gary L
authors.initials: GL
authors.lastname: Dillehay
authors.forename: Adam M
authors.initials: AM
authors.lastname: Petrich
authors.forename: Jessica K
authors.initials: JK
authors.lastname: Altman
authors.forename: Olga
authors.initials: O
authors.lastname: Frankfurt
authors.forename: Daina
authors.initials: D
authors.lastname: Variakojis
authors.forename: Seema
authors.initials: S
authors.lastname: Singhal
authors.forename: Jayesh
authors.initials: J
authors.lastname: Mehta
authors.forename: Stephanie
authors.initials: S
authors.lastname: Williams
authors.forename: Lynne
authors.initials: L
authors.lastname: Kaminer
authors.forename: Leo I
authors.initials: LI
authors.lastname: Gordon
authors.forename: Jane N
authors.initials: JN
authors.lastname: Winter
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D003131:Combined Modality Therapy; D005260:Female; D019788:Fluorodeoxyglucose F18; D018380:Hematopoietic Stem Cell Transplantation; D006689:Hodgkin Disease / Q000175:diagnosis* / Q000401:mortality / Q000628:therapy*; D006801:Humans; D015182:Lymphatic Irradiation; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D016609:Neoplasms, Second Primary / Q000209:etiology; D049268:Positron-Emission Tomography; D012008:Recurrence; D012074:Remission Induction; D016879:Salvage Therapy; D014182:Transplantation, Autologous; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D019788:Fluorodeoxyglucose F18
keywords: Hodgkin lymphoma; chemotherapy; positron emission tomography; radiotherapy; stem cell transplant