M Picardi1, A Soricelli2, F Grimaldi1, E Nicolai2, A Gallamini3, F Pane4. 1. Division of Hematology, Department of Biochemistry and Medical Biotechnology, University of Naples 'Federico II' University Medical School, Naples. 2. Fondazione SDN, Naples. 3. Hematology Department, S. Croce e Carle Hospital, Cuneo, Italy. 4. Division of Hematology, Department of Biochemistry and Medical Biotechnology, University of Naples 'Federico II' University Medical School, Naples. Electronic address: fabpane@unina.it.
Abstract
BACKGROUND: Spleen and liver assessment for occult involvement of Hodgkin's lymphoma (HL) challenges current staging procedures. PATIENTS AND METHODS: We prospectively evaluated event-free survival (EFS) in 103 HL patients staged with fused 2-[fluorine-18]fluoro-2-deoxy-D-glucose-positron emission tomography (FDG-PET)/contrast-enhanced computed tomography (CT) to identify those at greatest risk for abdominal relapse. The EFS of this series was compared with that of a historical cohort of 100 HL patients staged with separate FDG-PET and diagnostic CT acquisitions. RESULTS: Thirty-one of the 103 patients staged with FDG-PET/contrast-enhanced CT were found to have spleen involvement and 10 patients liver involvement, whereas 14 of the 100 patients staged with separate procedures were found to have spleen involvement and 3 patients liver involvement. There were significantly more intensive treatments (six courses of anthracycline-containing chemotherapy and spleen radiation) in the fused PET/CT group than in the historical cohort (P ≤ 0.04). At a median follow-up of 27 months, five events occurred in the fused PET/CT group (HL relapse, 4 patients; carcinoma, 1 patient) and 19 events in the historical cohort (HL relapse, 18 patients; acute promyelocytic leukemia, 1 patient). Ten of the 18 relapses in the historical cohort were localized in the spleen and/or liver area. None of the four relapses in the fused PET/CT group was localized below the diaphragm. Thus, FDG-PET/contrast-enhanced CT-guided treatment resulted in a 95% EFS, whereas separate FDG-PET and diagnostic CT-guided treatment resulted in an 81% EFS (P = 0.002). CONCLUSION: FDG-PET/contrast-enhanced CT is an accurate frontline single imaging diagnostic tool enabling effective tailored treatment in HL patients.
BACKGROUND: Spleen and liver assessment for occult involvement of Hodgkin's lymphoma (HL) challenges current staging procedures. PATIENTS AND METHODS: We prospectively evaluated event-free survival (EFS) in 103 HL patients staged with fused 2-[fluorine-18]fluoro-2-deoxy-D-glucose-positron emission tomography (FDG-PET)/contrast-enhanced computed tomography (CT) to identify those at greatest risk for abdominal relapse. The EFS of this series was compared with that of a historical cohort of 100 HL patients staged with separate FDG-PET and diagnostic CT acquisitions. RESULTS: Thirty-one of the 103 patients staged with FDG-PET/contrast-enhanced CT were found to have spleen involvement and 10 patients liver involvement, whereas 14 of the 100 patients staged with separate procedures were found to have spleen involvement and 3 patients liver involvement. There were significantly more intensive treatments (six courses of anthracycline-containing chemotherapy and spleen radiation) in the fused PET/CT group than in the historical cohort (P ≤ 0.04). At a median follow-up of 27 months, five events occurred in the fused PET/CT group (HL relapse, 4 patients; carcinoma, 1 patient) and 19 events in the historical cohort (HL relapse, 18 patients; acute promyelocytic leukemia, 1 patient). Ten of the 18 relapses in the historical cohort were localized in the spleen and/or liver area. None of the four relapses in the fused PET/CT group was localized below the diaphragm. Thus, FDG-PET/contrast-enhanced CT-guided treatment resulted in a 95% EFS, whereas separate FDG-PET and diagnostic CT-guided treatment resulted in an 81% EFS (P = 0.002). CONCLUSION: FDG-PET/contrast-enhanced CT is an accurate frontline single imaging diagnostic tool enabling effective tailored treatment in HL patients.
Authors: Roberta Della Pepa; Claudio Cerchione; Novella Pugliese; Roberta Colicchio; Paola Salvatore; Cesare Sirignano; Ernesto Soscia; Livio Pagano; Maurizio Sanguinetti; Fabrizio Pane; Marco Picardi Journal: Support Care Cancer Date: 2018-03-09 Impact factor: 3.603
Authors: M Picardi; C Cavaliere; R Della Pepa; E Nicolai; A Soricelli; C Giordano; N Pugliese; M G Rascato; I Cappuccio; G Campagna; C Cerchione; E Vigliar; G Troncone; M Mascolo; M Franzese; R Castaldo; M Salvatore; F Pane Journal: Ann Hematol Date: 2021-04-28 Impact factor: 3.673
Authors: Agostino Chiaravalloti; Roberta Danieli; Cristiana Ragano Caracciolo; Laura Travascio; Maria Cantonetti; Andrea Gallamini; Manlio Guazzaroni; Antonio Orlacchio; Giovanni Simonetti; Orazio Schillaci Journal: Medicine (Baltimore) Date: 2014-08 Impact factor: 1.889
Authors: Marco Picardi; Claudia Giordano; Novella Pugliese; Maria Esposito; Melania Fatigati; Francesco Muriano; Maria G Rascato; Roberta Della Pepa; Alessandro D'Ambrosio; Elena Vigliar; Giancarlo Troncone; Daniela Russo; Massimo Mascolo; Giovanni Esposito; Mariella Prastaro; Roberta Esposito; Carlo G Tocchetti; Rosa Fonti; Ciro Mainolfi; Silvana Del Vecchio; Fabrizio Pane Journal: Br J Haematol Date: 2022-07-12 Impact factor: 8.615