Luca Ceriani1, Maurizio Martelli2, Maria K Gospodarowicz3, Umberto Ricardi4, Andrés J M Ferreri5, Annalisa Chiappella6, Caterina Stelitano7, Monica Balzarotti8, Maria E Cabrera9, David Cunningham10, Attilio Guarini11, Pier Luigi Zinzani12, Luca Giovanella13, Peter W M Johnson14, Emanuele Zucca15. 1. Nuclear Medicine and PET-CT Center, Oncology Institute of Southern Switzerland, Bellinzona, Switzerland. Electronic address: luca.ceriani@eoc.ch. 2. Department of Cellular Biotechnologies and Hematology, Sapienza University, Rome, Italy. 3. Radiation Oncology, University of Toronto, Toronto, Ontario, Canada. 4. Department of Oncology, University of Torino, Torino, Italy. 5. Unit of Lymphoid Malignancies, Department of Onco-Hematology, Istituto Di Ricovero e Cura a Carattere Scientifico (IRCCS) San Raffaele Scientific Institute, Milano, Italy. 6. Hematology, Azienda Ospedaliera Universitaria Città della Salute e della Scienza, Torino, Italy. 7. Hematology, Azienda Ospedaliera Bianchi-Melacrino-Morelli, Reggio Calabria, Italy. 8. Hematology, IRCCS Humanitas Cancer Center, Rozzano, Milan, Italy. 9. Hematology, Hospital del Salvador, Universidad de Chile, Santiago, Chile. 10. Department of Medicine, The Royal Marsden National Health Service Foundation Trust, London and Surrey, United Kingdom. 11. Hematology Unit, Istituto Nazionale Tumori Giovanni Paolo II IRCCS, Bari, Italy. 12. Institute of Hematology and Medical Oncology, Policlinico S.Orsola-Malpighi, Bologna, Italy. 13. Nuclear Medicine and PET-CT Center, Oncology Institute of Southern Switzerland, Bellinzona, Switzerland. 14. Cancer Research UK Centre, University of Southampton, Southampton, United Kingdom. 15. Oncology Department, Oncology Institute of Southern Switzerland, Bellinzona, Switzerland.
Abstract
PURPOSE: To assess the predictive value of 18F-fluorodeoxyglucose positron emission tomography/computed tomography (PET/CT) for disease recurrence after immunochemotherapy (R-CHT) and mediastinal irradiation (RT), using the recently published criteria of the Lugano classification to predict outcomes for patients with primary mediastinal large B-cell lymphoma. METHODS AND MATERIALS: Among 125 patients prospectively enrolled in the IELSG-26 study, 88 were eligible for central review of PET/CT scans after completion of RT. Responses were evaluated using the 5-point Deauville scale at the end of induction R-CHT and after consolidation RT. According to the Lugano classification, a complete metabolic response (CMR) was defined by a Deauville score (DS) ≤3. RESULTS: The CMR (DS1, -2, or -3) rate increased from 74% (65 patients) after R-CHT to 89% (78 patients) after consolidation RT. Among the 10 patients (11%) with persistently positive scans, the residual uptake after RT was slightly higher than the liver uptake in 6 patients (DS4; 7%) and markedly higher in 4 patients (DS5; 4%): these patients had a significantly poorer 5-year progression-free survival and overall survival. At a median follow-up of 60 months (range, 35-107 months), no patients with a CMR after RT have relapsed. Among the 10 patients who did not reach a CMR, 3 of the 4 patients (positive predictive value, 75%) with DS5 after RT had subsequent disease progression (within the RT volume in all cases) and died. All patients with DS4 had good outcomes without recurrence. CONCLUSIONS: All the patients obtaining a CMR defined as DS ≤3 remained progression-free at 5 years, confirming the excellent negative predictive value of the Lugano classification criteria in primary mediastinal large B-cell lymphoma patients. The few patients with DS4 also had an excellent outcome, suggesting that they do not necessarily require additional therapy, because the residual 18F-fluorodeoxyglucose uptake may not reflect persistent lymphoma.
PURPOSE: To assess the predictive value of 18F-fluorodeoxyglucose positron emission tomography/computed tomography (PET/CT) for disease recurrence after immunochemotherapy (R-CHT) and mediastinal irradiation (RT), using the recently published criteria of the Lugano classification to predict outcomes for patients with primary mediastinal large B-cell lymphoma. METHODS AND MATERIALS: Among 125 patients prospectively enrolled in the IELSG-26 study, 88 were eligible for central review of PET/CT scans after completion of RT. Responses were evaluated using the 5-point Deauville scale at the end of induction R-CHT and after consolidation RT. According to the Lugano classification, a complete metabolic response (CMR) was defined by a Deauville score (DS) ≤3. RESULTS: The CMR (DS1, -2, or -3) rate increased from 74% (65 patients) after R-CHT to 89% (78 patients) after consolidation RT. Among the 10 patients (11%) with persistently positive scans, the residual uptake after RT was slightly higher than the liver uptake in 6 patients (DS4; 7%) and markedly higher in 4 patients (DS5; 4%): these patients had a significantly poorer 5-year progression-free survival and overall survival. At a median follow-up of 60 months (range, 35-107 months), no patients with a CMR after RT have relapsed. Among the 10 patients who did not reach a CMR, 3 of the 4 patients (positive predictive value, 75%) with DS5 after RT had subsequent disease progression (within the RT volume in all cases) and died. All patients with DS4 had good outcomes without recurrence. CONCLUSIONS: All the patients obtaining a CMR defined as DS ≤3 remained progression-free at 5 years, confirming the excellent negative predictive value of the Lugano classification criteria in primary mediastinal large B-cell lymphomapatients. The few patients with DS4 also had an excellent outcome, suggesting that they do not necessarily require additional therapy, because the residual 18F-fluorodeoxyglucose uptake may not reflect persistent lymphoma.
Authors: Vitaliana DE Sanctis; Alice DI Rocco; Maria Christina Cox; Maurizio Valeriani; Francesca Perrone Congedi; Dimitri Anzellini; Maria Massaro; Gianluca Vullo; Giuseppe Facondo; Flavia DE Giacomo; Marco Alfò; Daniela Prosperi; Patrizia Pizzichini; Sabrina Pelliccia; Agostino Tafuri; Maurizio Martelli; Mattia Falchetto Osti Journal: In Vivo Date: 2020 May-Jun Impact factor: 2.155
Authors: Sally F Barrington; Elizabeth H Phillips; Nicholas Counsell; Barry Hancock; Ruth Pettengell; Peter Johnson; William Townsend; Dominic Culligan; Bilyana Popova; Laura Clifton-Hadley; Andrew McMillan; Peter Hoskin; Michael J O'Doherty; Tim Illidge; John Radford Journal: J Clin Oncol Date: 2019-05-21 Impact factor: 44.544
Authors: Sally F Barrington; Farheen Mir; Tarec Christoffer El-Galaly; Andrea Knapp; Tina G Nielsen; Denis Sahin; Michael Wenger; Lale Kostakoglu; Judith Trotman; Michel Meignan Journal: J Nucl Med Date: 2021-12-02 Impact factor: 11.082
Authors: Chelsea C Pinnix; Andrea K Ng; Bouthaina S Dabaja; Sarah A Milgrom; Jillian R Gunther; C David Fuller; Grace L Smith; Zeinab Abou Yehia; Wei Qiao; Christine F Wogan; Mani Akhtari; Osama Mawlawi; L Jeffrey Medeiros; Hubert H Chuang; William Martin-Doyle; Philippe Armand; Ann S LaCasce; Yasuhiro Oki; Michelle Fanale; Jason Westin; Sattva Neelapu; Loretta Nastoupil Journal: Blood Adv Date: 2018-06-12
Authors: Sally F Barrington; Jakoba J Eertink; Henrika C W de Vet; N George Mikhaeel; Otto S Hoekstra; Josee M Zijlstra Journal: J Nucl Med Date: 2021-04-23 Impact factor: 11.082