title: Serum thymus and activation-regulated chemokine level monitoring may predict disease relapse detected by PET scan after reduced-intensity allogeneic stem cell transplantation in patients with Hodgkin lymphoma.
abstract: Patients with relapsed and refractory Hodgkin lymphoma (HL) may experience long-term survival after allogeneic stem cell transplantation (alloSCT), but disease recurrence represents the main cause of treatment failure. Positron-emission tomography (PET)-positive patients after alloSCT have a dismal outcome. Serum thymus and activation-regulated chemokine (TARC) is produced by Reed-Sternberg cells and may be a marker of disease. Our study aimed at assessing whether TARC levels after alloSCT correlated with disease status and whether TARC monitoring could increase the ability to predict relapse. Twenty-four patients were evaluated in a prospective observational study. TARC serum level and PET were assessed before and after alloSCT during the follow-up (median, 30 months; range, 2 to 54). Before alloSCT, the median TARC level was 721 pg/mL (range, 209 to 1332) in PET-negative patients and 2542 pg/mL (range, 94 to 13,870) in PET-positive patients. After alloSCT, TARC was 620 pg/mL (range, 12 to 4333) in persistently PET-negative patients compared with 22,397 pg/mL (range, 602 to 106,578) in PET-positive patients (P < .0001). In 7 patients who relapsed after alloSCT, TARC level increased progressively even before PET became positive, with a median fold increase of 3.19 (range, 1.66 to 7.11) at relapse. The cut-off value of 1726 pg/mL had a sensitivity of 100% and a specificity of 71% for PET positivity. Patients with at least 1 TARC value above 1726 pg/mL during the first year after alloSCT had a worse progression-free survival (P = .031). In conclusion, TARC was correlated with disease status and its monitoring may be able to predict PET positivity after alloSCT, thus potentially allowing an early immune manipulation.
authors.affiliation: Hematology Department, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy. Electronic address: lucia.farina@istitutotumori.mi.it.
authors.forename: Lucia
authors.initials: L
authors.lastname: Farina
authors.affiliation: Hematology Department, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy.
authors.forename: Francesca
authors.initials: F
authors.lastname: Rezzonico
authors.affiliation: Hematology Department, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy.
authors.forename: Francesco
authors.initials: F
authors.lastname: Spina
authors.affiliation: Hematology Department, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy.
authors.forename: Anna
authors.initials: A
authors.lastname: Dodero
authors.affiliation: Transfusion Medicine Service, Hematology Department, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy.
authors.forename: Arabella
authors.initials: A
authors.lastname: Mazzocchi
authors.affiliation: Department of Nuclear Medicine, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy.
authors.forename: Flavio
authors.initials: F
authors.lastname: Crippa
authors.affiliation: Department of Nuclear Medicine, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy.
authors.forename: Alessandra
authors.initials: A
authors.lastname: Alessi
authors.affiliation: Hematology Department, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy.
authors.forename: Serena
authors.initials: S
authors.lastname: Dalto
authors.affiliation: Medical Oncology, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy.
authors.forename: Simonetta
authors.initials: S
authors.lastname: Viviani
authors.affiliation: Hematology Department, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy; Hematology Department, Università degli Studi di Milano, Milan, Italy.
authors.forename: Paolo
authors.initials: P
authors.lastname: Corradini
mesh_terms: D000293:Adolescent; D000328:Adult; D064591:Allografts; D054414:Chemokine CCL17 / Q000097:blood*; D018572:Disease-Free Survival; D005260:Female; D006689:Hodgkin Disease / Q000097:blood / Q000000981:diagnostic imaging / Q000401:mortality / Q000628:therapy; D006801:Humans; D008297:Male; D008875:Middle Aged; D008991:Monitoring, Physiologic; D049268:Positron-Emission Tomography; D011859:Radiography; D012008:Recurrence; D012189:Retrospective Studies; D033581:Stem Cell Transplantation; D015996:Survival Rate
chemical_list: C106230:CCL17 protein, human; D054414:Chemokine CCL17
keywords: Allogeneic stem cell transplantation; Hodgkin lymphoma; Thymus and activation-regulated chemokine (TARC)