Abstract
Purpose In the present study, we mainly aimed to evaluate the prognostic value of 2-deoxy-2-[18F]fluoro-D-glucose ([18F]F-FDG) positron emission tomography (PET)/computed tomography (CT) after autologous stem cell transplantation (ASCT) in lymphoma. Procedures. A total of 76 lymphoma patients who benefited from [18F]F-FDG PET-CT (within 3 months and 3–6 months) after ASCT in our institution between April 2010 and December 2019 were enrolled in this retrospective study. These abovementioned patients were divided into two groups based on the Deauville criteria. The Kaplan–Meier method was used in survival analysis, and the log-rank method was adopted in comparison. Prognostic factor analysis was performed by the Cox regression model. Results Positive post-ASCT [18F]F-FDG PET-CT was associated with lower progression-free survival (PFS) and overall survival (OS) (p = 0.001 and p = 0.022, respectively). Univariate analysis showed the post-ASCT PET-CT result was the only independent factor associated with PFS (p = 0.002). Both the number of previous treatments and post-ASCT PET-CT result had a different impact on OS (p = 0.040 and p = 0.028, respectively). Multivariate analysis showed the post-ASCT PET-CT result was the only independent factor associated with OS (p = 0.028). The results showed no significant change from the abovementioned results when DS < 3 was defined as the negative result. For patients who had a PET-CT scan within 3–6 months after ASCT, the negative PET-CT group had a better prognosis including PFS and OS (p = 0.009 and p = 0.025, respectively). However, among the patients receiving PET-CT within 3 months, the result was not statistically significant (p = 0.064 and p = 0.445, respectively). Conclusion Collectively, we found that the post-ASCT [18F]F-FDG PET-CT was a strong indicator for PFS and OS, and a time window of 3–6 months was appropriate for post-ASCT [18F]F-FDG PET-CT. Trial registration number: ChiCTR2100042745.
Highlights
According to the statistics of GLOBOCAN 2018 produced by the International Agency for Research on Cancer, the number of new cases of Hodgkin’s lymphoma (HL) and non-Hodgkin’s lymphoma (NHL) is 79,990 and 509,590, respectively [1]
Salvage chemotherapy followed by high-dose chemotherapy and rescue autologous stem cell transplantation (ASCT) remains the standard therapeutic regimen for relapsed/refractory lymphoma [5, 6]. 2-Deoxy-2-[18F]fluoro-D-glucose positron emission tomography/computed tomography ([18F]F-FDG PET-CT) has become an important tool to evaluate the prognosis of lymphoma since PET-CT is incorporated into the National-Cancer-Institute-sponsored international consensus response criteria for lymphoma guidelines in 2007 [7,8,9]
The post-ASCT [18F] F-FDG PET-CT result was associated with both progression-free survival (PFS) and overall survival (OS)(p 0.005; HR, 3.477; 95% CI, 1.456–8.303 vs. p 0.036; HR, 5.205; 95% CI, 1.114–24.328)
Summary
According to the statistics of GLOBOCAN 2018 produced by the International Agency for Research on Cancer, the number of new cases of Hodgkin’s lymphoma (HL) and non-Hodgkin’s lymphoma (NHL) is 79,990 and 509,590, respectively [1]. 2-Deoxy-2-[18F]fluoro-D-glucose positron emission tomography/computed tomography ([18F]F-FDG PET-CT) has become an important tool to evaluate the prognosis of lymphoma since PET-CT is incorporated into the National-Cancer-Institute-sponsored international consensus response criteria for lymphoma guidelines in 2007 [7,8,9]. For lymphoma patients receiving ASCT, it has been shown that pretransplant PET-CT status is constantly and strongly associated with outcomes [9,10,11,12,13]. E Deauville score (DS) has been recommended as the preferred interpretation method for interim response evaluation [8, 14]. It still remains undetermined whether these Deauville criteria can be used in post-ASCT[18F]F-FDG PET-CT. Given that posttherapy inflammatory changes may contribute to the “falsepositive” PET-CT result, we hypothesized that a proper time window could help improve accuracy
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