title: Impact of Routine Surveillance Imaging on Outcomes of Patients With Diffuse Large B-Cell Lymphoma After Autologous Hematopoietic Cell Transplantation.
abstract: For patients with relapsed or refractory diffuse large B-cell lymphoma (DLBCL), autologous hematopoietic cell transplantation (auto-HCT) is commonly used. After auto-HCT, DLBCL patients are often monitored with surveillance imaging. However, there is little evidence to support this practice.
  
  
  
  We performed a multicenter retrospective study of DLBCL patients who underwent auto-HCT (n = 160), who experienced complete remission after transplantation, and who then underwent surveillance imaging. Of these, only 45 patients experienced relapse after day +100 after auto-HCT, with relapse detected by routine imaging in 32 (71%) and relapse detected clinically in 13 (29%).
  
  
  
  Baseline patient characteristics were similar between the 2 groups. Comparing the radiographic and clinically detected relapse groups, the median time from diagnosis to auto-HCT (389 days vs. 621 days, P = .06) and the median follow-up after auto-HCT (2464 days vs. 1593 days P = .60) were similar. The median time to relapse after auto-HCT was 191 days in radiographically detected relapses compared to 492 days in clinically detected relapses (P = .35), and median postrelapse survival was 359 days in such patients compared to 123 days in patients with clinically detected relapse (P = .36). However, the median posttransplantation overall survival was not significantly different for patients with relapse detected by routine imaging versus relapse detected clinically (643 vs. 586 days, P = .68).
  
  
  
  A majority (71%) of DLBCL relapses after auto-HCT are detected by routine surveillance imaging. Overall, there appears to be limited utility for routine imaging after auto-HCT except in select cases where earlier detection and salvage therapy with allogeneic HCT is a potential option.
authors.affiliation: Division of Hematology and Oncology, Medical College of Wisconsin, Milwaukee, WI.
authors.forename: Narendranath
authors.initials: N
authors.lastname: Epperla
authors.affiliation: Division of Hematology and Oncology, Medical College of Wisconsin, Milwaukee, WI.
authors.forename: Namrata
authors.initials: N
authors.lastname: Shah
authors.affiliation: Division of Hematology and Oncology, Medical College of Wisconsin, Milwaukee, WI.
authors.forename: Mehdi
authors.initials: M
authors.lastname: Hamadani
authors.affiliation: Department of Medicine, Rush University Medical Center, Chicago, IL.
authors.forename: Kristin
authors.initials: K
authors.lastname: Richardson
authors.affiliation: Department of Medicine, Medical College of Wisconsin, Milwaukee, WI.
authors.forename: Jonathan T
authors.initials: JT
authors.lastname: Kapke
authors.affiliation: Division of Hematology and Oncology, Houston Methodist Cancer Center, Houston, TX.
authors.forename: Asmita
authors.initials: A
authors.lastname: Patel
authors.affiliation: Division of Hematology and Oncology, Houston Methodist Cancer Center, Houston, TX.
authors.forename: Sravanthi P
authors.initials: SP
authors.lastname: Teegavarapu
authors.affiliation: Center for Cell and Gene Therapy, Baylor College of Medicine, Texas Children's Hospital and Houston Methodist Hospital, Houston, TX.
authors.forename: George
authors.initials: G
authors.lastname: Carrum
authors.affiliation: Division of Hematology and Oncology, Medical College of Wisconsin, Milwaukee, WI.
authors.forename: Parameswaran N
authors.initials: PN
authors.lastname: Hari
authors.affiliation: Division of Hematology and Oncology, Houston Methodist Cancer Center, Houston, TX.
authors.forename: Sai R
authors.initials: SR
authors.lastname: Pingali
authors.affiliation: Division of Hematology, Oncology, and Cell Therapy, Rush University Medical Center, Chicago, IL.
authors.forename: Reem
authors.initials: R
authors.lastname: Karmali
authors.affiliation: Division of Hematology and Oncology, Medical College of Wisconsin, Milwaukee, WI. Electronic address: tfenske@mcw.edu.
authors.forename: Timothy S
authors.initials: TS
authors.lastname: Fenske
mesh_terms: D003131:Combined Modality Therapy; D003952:Diagnostic Imaging / Q000379:methods; D005260:Female; D018380:Hematopoietic Stem Cell Transplantation / Q000379:methods; D006801:Humans; D016403:Lymphoma, Large B-Cell, Diffuse / Q000000981:diagnostic imaging* / Q000401:mortality / Q000628:therapy; D008297:Male; D008991:Monitoring, Physiologic; D009367:Neoplasm Staging; D000072078:Positron Emission Tomography Computed Tomography; D049268:Positron-Emission Tomography; D011182:Postoperative Care; D012008:Recurrence; D012189:Retrospective Studies; D016019:Survival Analysis; D013997:Time Factors; D014057:Tomography, X-Ray Computed; D014182:Transplantation, Autologous; D016896:Treatment Outcome; D057188:Workflow
keywords: Auto-HCT; Clinical; DLBCL; Radiographic; Relapse