Zhitao Ying1, Lan Mi2, Nina Zhou3, Xuejuan Wang3, Zhi Yang3, Yuqin Song1, Xiaopei Wang1, Wen Zheng1, Ningjing Lin1, Meifeng Tu1, Yan Xie1, Lingyan Ping1, Chen Zhang1, Weiping Liu1, Lijuan Deng1, Jun Zhu1. 1. Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Department of Lymphoma, Peking University Cancer Hospital & Institute, Beijing 100142, China. 2. Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Peking University Cancer Hospital & Institute, Beijing 100142, China. 3. Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Department of Nuclear Medicine, Peking University Cancer Hospital & Institute, Beijing 100142, China.
Abstract
OBJECTIVE: High-dose chemotherapy (HDC) followed by autologous hematopoietic stem cell transplantation (auto-HSCT) plays an important role in improving outcomes of diffuse large B cell lymphoma (DLBCL) patients. 18F-fluorodeoxyglucose (18F-FDG) positron emission tomography (PET)/computed tomography (CT) has been widely accepted in response assessment and prediction of prognosis in DLBCL. Here, we report the value of 18F-FDG PET/CT pre- and post-HSCT in predicting outcomes of patients with DLBCL. METHODS: DLBCL patients who had PET/CT scan before and after HSCT were included. PET results were interpreted based upon Deauville criteria. The prognostic value of 18F-FDG PET/CT in auto-HSCT was evaluated. RESULTS: Eighty-four patients were enrolled. In univariate analysis, pre- and post-HSCT PET findings were correlated with 3-year progression-free survival (PFS) [hazard ratio (HR)=4.391, P=0.001; HR=7.607, P<0.001] and overall survival (OS) (HR=4.792, P=0.008; HR=26.138, P<0.001). Patients receiving upfront auto-HSCT after first-line treatment had better outcomes than relapsed/refractory DLBCL patients (3-year PFS, P<0.001; 3-year OS, P<0.001). In the relapsed/refractory patients, pre- and post-HSCT PET findings were also associated with 3-year PFS (P=0.003vs. P<0.001) and OS (P=0.027vs. P<0.001). A significant correlation was observed between clinical response to chemotherapy before auto-HSCT and outcomes of patients in the entire cohort (3-year PFS, P<0.001; 3-year OS, P<0.001) and in the subgroup of 21 patients with positive pre-HSCT PET (3-year PFS, P=0.084; 3-year OS, P=0.240). A significant association between survival and post-HSCT PET findings was observed in multivariate analysis (HR=5.168, P<0.001). CONCLUSIONS: PET results before and after HSCT are useful prognostic factors for DLBCL patients receiving HSCT. Patients who responded to chemotherapy, even those with positive pre-HSCT PET, are appropriate candidates for auto-HSCT.
OBJECTIVE: High-dose chemotherapy (HDC) followed by autologous hematopoietic stem cell transplantation (auto-HSCT) plays an important role in improving outcomes of diffuse large B cell lymphoma (DLBCL) patients. 18F-fluorodeoxyglucose (18F-FDG) positron emission tomography (PET)/computed tomography (CT) has been widely accepted in response assessment and prediction of prognosis in DLBCL. Here, we report the value of 18F-FDG PET/CT pre- and post-HSCT in predicting outcomes of patients with DLBCL. METHODS: DLBCL patients who had PET/CT scan before and after HSCT were included. PET results were interpreted based upon Deauville criteria. The prognostic value of 18F-FDG PET/CT in auto-HSCT was evaluated. RESULTS: Eighty-four patients were enrolled. In univariate analysis, pre- and post-HSCT PET findings were correlated with 3-year progression-free survival (PFS) [hazard ratio (HR)=4.391, P=0.001; HR=7.607, P<0.001] and overall survival (OS) (HR=4.792, P=0.008; HR=26.138, P<0.001). Patients receiving upfront auto-HSCT after first-line treatment had better outcomes than relapsed/refractory DLBCL patients (3-year PFS, P<0.001; 3-year OS, P<0.001). In the relapsed/refractory patients, pre- and post-HSCT PET findings were also associated with 3-year PFS (P=0.003vs. P<0.001) and OS (P=0.027vs. P<0.001). A significant correlation was observed between clinical response to chemotherapy before auto-HSCT and outcomes of patients in the entire cohort (3-year PFS, P<0.001; 3-year OS, P<0.001) and in the subgroup of 21 patients with positive pre-HSCT PET (3-year PFS, P=0.084; 3-year OS, P=0.240). A significant association between survival and post-HSCT PET findings was observed in multivariate analysis (HR=5.168, P<0.001). CONCLUSIONS: PET results before and after HSCT are useful prognostic factors for DLBCL patients receiving HSCT. Patients who responded to chemotherapy, even those with positive pre-HSCT PET, are appropriate candidates for auto-HSCT.
Entities:
Keywords:
Positron emission tomography; autologous hematopoietic stem cell transplantation; computed tomography; diffuse large B cell lymphoma; high-dose chemotherapy
Authors: Michael Dickinson; Rosemary Hoyt; Andrew W Roberts; Andrew Grigg; John F Seymour; H Miles Prince; Jeff Szer; David Ritchie Journal: Br J Haematol Date: 2010-05-07 Impact factor: 6.998
Authors: Paul A Hamlin; Andrew D Zelenetz; Tarun Kewalramani; Jing Qin; Jaya M Satagopan; David Verbel; Ariela Noy; Carol S Portlock; David J Straus; Joachim Yahalom; Stephen D Nimer; Craig H Moskowitz Journal: Blood Date: 2003-04-03 Impact factor: 22.113
Authors: V Roland; C Bodet-Milin; A Moreau; T Gastinne; B Mahé; V Dubruille; H Maisonneuve; N Juge-Morineau; P Moreau; H Jardel; L Planche; M Mohty; P Moreau; J-L Harousseau; F Kraeber-Bodéré; S Le Gouill Journal: Bone Marrow Transplant Date: 2010-05-31 Impact factor: 5.483
Authors: Norbert Schmitz; Maike Nickelsen; Marita Ziepert; Mathias Haenel; Peter Borchmann; Christian Schmidt; Andreas Viardot; Martin Bentz; Norma Peter; Gerhard Ehninger; Gottfried Doelken; Christian Ruebe; Lorenz Truemper; Andreas Rosenwald; Michael Pfreundschuh; Markus Loeffler; Bertram Glass Journal: Lancet Oncol Date: 2012-11-16 Impact factor: 41.316
Authors: Christian Gisselbrecht; Bertram Glass; Nicolas Mounier; Devinder Singh Gill; David C Linch; Marek Trneny; Andre Bosly; Nicolas Ketterer; Ofer Shpilberg; Hans Hagberg; David Ma; Josette Brière; Craig H Moskowitz; Norbert Schmitz Journal: J Clin Oncol Date: 2010-07-26 Impact factor: 44.544
Authors: J Dupuis; E Itti; A Rahmouni; F Hemery; C Gisselbrecht; C Lin; C Copie-Bergman; K Belhadj; T El Gnaoui; I Gaillard; F Kuhnowski; M Meignan; C Haioun Journal: Ann Oncol Date: 2008-12-11 Impact factor: 32.976