Tiffany Tang1, Zhengming Chen2, Pannee Praditsuktavorn3, Lay Poh Khoo4, Jia Ruan3, Soon Thye Lim4, Daryl Tan5, Colin Phipps5, Yuh Shan Lee5, Yeow Tee Goh5, William Hwang5, Miriam Tao4, Richard Quek4, Mohamad Farid4, Richard R Furman3, John P Leonard3, Peter Martin3. 1. Division of Medical Oncology, National Cancer Centre Singapore, Singapore, Singapore; Division of Hematology and Oncology, Weill Cornell Medical College, New York, NY. Electronic address: Tiffany.Tang.P.L@nccs.com.sg. 2. Division of Biostatistics and Epidemiology, Department of Healthcare Policy and Research, Weill Cornell Medical College, New York, NY. 3. Division of Hematology and Oncology, Weill Cornell Medical College, New York, NY. 4. Division of Medical Oncology, National Cancer Centre Singapore, Singapore, Singapore. 5. Department of Hematology, Singapore General Hospital, Singapore, Singapore.
Abstract
INTRODUCTION: The role of surveillance imaging (SI) in patients with peripheral T-cell lymphoma (PTCL) in first complete remission (CR1) is unclear. MATERIALS AND METHODS: Patients with PTCL were identified through prospectively maintained T-cell lymphoma databases from the National Cancer Centre Singapore/Singapore General Hospital and Weill-Cornell Medical College after institutional review board approval. Patients with leukemia or indolent, composite, and cutaneous lymphomas were excluded. The patients' medical records were retrospectively reviewed to determine the frequency and type of SI used. Of those with relapse, the method of relapse detection and data on symptoms, signs, and elevated lactate dehydrogenase LDH were extracted. RESULTS: A total of 338 patients were included in the present study. In the first year after achieving CR1, patients had an average of 1.2 and a median of 1 SI performed (range, 0-4). In the second year after achieving CR1, they had an average of 0.78 and a median of 1 SI performed (range, 0-4). Of the 135 patients who achieved CR1, 61 (45%) developed a relapse. Relapses were detected before SI in 48 (84%), and 9 patients had relapses detected during routine SI. Of the 9 patients whose relapses were detected during planned SI, only 3 did not have any symptoms or signs suggestive of relapsed disease. Of these 3 patients, 2 had angioimmunoblastic T-cell lymphoma and 1 had natural killer/T-cell lymphoma. CONCLUSION: Most PTCL relapses were detected before planned SI, and most patients had symptoms with relapse. Only 3 patients (5.2%) were completely asymptomatic at relapse, suggesting a limited utility of routine imaging for detecting PTCL relapses.
INTRODUCTION: The role of surveillance imaging (SI) in patients with peripheral T-cell lymphoma (PTCL) in first complete remission (CR1) is unclear. MATERIALS AND METHODS:Patients with PTCL were identified through prospectively maintained T-cell lymphoma databases from the National Cancer Centre Singapore/Singapore General Hospital and Weill-Cornell Medical College after institutional review board approval. Patients with leukemia or indolent, composite, and cutaneous lymphomas were excluded. The patients' medical records were retrospectively reviewed to determine the frequency and type of SI used. Of those with relapse, the method of relapse detection and data on symptoms, signs, and elevated lactate dehydrogenase LDH were extracted. RESULTS: A total of 338 patients were included in the present study. In the first year after achieving CR1, patients had an average of 1.2 and a median of 1 SI performed (range, 0-4). In the second year after achieving CR1, they had an average of 0.78 and a median of 1 SI performed (range, 0-4). Of the 135 patients who achieved CR1, 61 (45%) developed a relapse. Relapses were detected before SI in 48 (84%), and 9 patients had relapses detected during routine SI. Of the 9 patients whose relapses were detected during planned SI, only 3 did not have any symptoms or signs suggestive of relapsed disease. Of these 3 patients, 2 had angioimmunoblastic T-cell lymphoma and 1 had natural killer/T-cell lymphoma. CONCLUSION: Most PTCL relapses were detected before planned SI, and most patients had symptoms with relapse. Only 3 patients (5.2%) were completely asymptomatic at relapse, suggesting a limited utility of routine imaging for detecting PTCL relapses.
Authors: Ka-Won Kang; Se Ryeon Lee; Dae Sik Kim; Eun Sang Yu; Hwa Jung Sung; Seok Jin Kim; Chul Won Choi; Yong Park; Byung Soo Kim Journal: PLoS One Date: 2018-02-14 Impact factor: 3.240