BACKGROUND: Approximately one-third of the patients with relapsed aggressive non-Hodgkin's lymphoma (NHL) are cured by second-line chemotherapy followed by high-dose consolidation. The age-adjusted international prognostic index determined at the time of relapse (sAAIPI) predicts outcome in relapsed diffuse large B-cell lymphoma, suggesting that the success of salvage therapy could be enhanced by early relapse detection. This study evaluated the role of surveillance imaging in detection of relapsed disease and its impact on outcome of salvage treatment. PATIENTS AND METHODS: One hundred and eight patients with relapsed aggressive NHL were treated with ICE-based second-line chemotherapy. Relapses were categorized as detected by imaging, examination, or patient-reported symptoms. RESULTS: Twenty per cent of relapses were detected by routine imaging while 80% were identified by reported symptoms or abnormalities on exam. Patients were 4.1 times (95% CI: 1.7-10.2) more likely to have low risk disease if relapse was diagnosed by routine imaging (group 1) compared with those diagnosed by reported symptoms or physical findings (group 2). Median overall 5-year survival for group 1 versus group 2 was 54% and 43% respectively (P = 0.13). CONCLUSION: These results suggest that routine surveillance imaging can identify a population of patients with a more favorable outcome based on the sAAIPI.
BACKGROUND: Approximately one-third of the patients with relapsed aggressive non-Hodgkin's lymphoma (NHL) are cured by second-line chemotherapy followed by high-dose consolidation. The age-adjusted international prognostic index determined at the time of relapse (sAAIPI) predicts outcome in relapsed diffuse large B-cell lymphoma, suggesting that the success of salvage therapy could be enhanced by early relapse detection. This study evaluated the role of surveillance imaging in detection of relapsed disease and its impact on outcome of salvage treatment. PATIENTS AND METHODS: One hundred and eight patients with relapsed aggressive NHL were treated with ICE-based second-line chemotherapy. Relapses were categorized as detected by imaging, examination, or patient-reported symptoms. RESULTS: Twenty per cent of relapses were detected by routine imaging while 80% were identified by reported symptoms or abnormalities on exam. Patients were 4.1 times (95% CI: 1.7-10.2) more likely to have low risk disease if relapse was diagnosed by routine imaging (group 1) compared with those diagnosed by reported symptoms or physical findings (group 2). Median overall 5-year survival for group 1 versus group 2 was 54% and 43% respectively (P = 0.13). CONCLUSION: These results suggest that routine surveillance imaging can identify a population of patients with a more favorable outcome based on the sAAIPI.
Authors: Jessica Hunn; Meaghan E Tenney; Ana I Tergas; Erin A Bishop; Kathleen Moore; William Watkin; Carolyn Kirschner; Jean Hurteau; Gustavo C Rodriguez; Ernst Lengyel; Nita K Lee; S Diane Yamada Journal: Gynecol Oncol Date: 2015-03-30 Impact factor: 5.482
Authors: Carrie A Thompson; Herve Ghesquieres; Matthew J Maurer; James R Cerhan; Pierre Biron; Stephen M Ansell; Catherine Chassagne-Clément; David J Inwards; Thérèse Gargi; Patrick B Johnston; Emmanuelle Nicolas-Virelizier; William R Macon; Marie Peix; Ivana N Micallef; Catherine Sebban; Grzegorz S Nowakowski; Luis F Porrata; George J Weiner; Thomas E Witzig; Thomas M Habermann; Brian K Link Journal: J Clin Oncol Date: 2014-09-29 Impact factor: 44.544
Authors: Mark Roschewski; Kieron Dunleavy; Stefania Pittaluga; Martin Moorhead; Francois Pepin; Katherine Kong; Margaret Shovlin; Elaine S Jaffe; Louis M Staudt; Catherine Lai; Seth M Steinberg; Clara C Chen; Jianbiao Zheng; Thomas D Willis; Malek Faham; Wyndham H Wilson Journal: Lancet Oncol Date: 2015-04-01 Impact factor: 41.316