Abstract
This study aimed to systematically review the prognostic value of pretransplant 18F-fluoro-2-deoxy-D-glucose positron emission tomography (FDG-PET) in refractory/relapsed Hodgkin lymphoma treated with autologous stem cell transplantation (SCT). MEDLINE was systematically searched for appropriate studies. Included studies were methodologically appraised. Results of individual studies were meta-analyzed, if possible. Eleven studies, comprising a total of 745 refractory/relapsed Hodgkin lymphoma patients who underwent FDG-PET before autologous SCT, were included. The overall methodological quality of these studies was moderate. The proportion of pretransplant FDG-PET positive patients ranged between 25 and 65.2 %. Progression-free survival ranged between 0 and 52 % in pretransplant FDG-PET positive patients, and between 55 and 85 % in pretransplant FDG-PET negative patients. Overall survival ranged between 17 and 77 % in pretransplant FDG-PET positive patients, and between 78 and 100 % in FDG-PET negative patients. Based on five studies that provided sufficient data for meta-analysis, pooled sensitivity and specificity of pretransplant FDG-PET in predicting treatment failure (i.e., either progressive, residual, or relapsed disease) were 67.2 % (95 % confidence interval [CI] 58.2–75.3 %) and 70.7 % (95 % CI 64.2–76.5 %), respectively. Based on two studies that provided sufficient data for meta-analysis, pooled sensitivity and specificity of pretransplant FDG-PET in predicting death during follow-up were 74.4 % (95 % CI 58.8–86.5 %) and 58.0 % (95 % CI 49.3–66.3 %), respectively. In conclusion, the moderate quality evidence suggests pretransplant FDG-PET to have value in predicting outcome in refractory/relapsed Hodgkin lymphoma patients treated with autologous SCT. Nevertheless, a considerable proportion of pretransplant FDG-PET positive patients remains disease free and a considerable proportion of pretransplant FDG-PET negative patients develops disease relapse after autologous SCT.
Highlights
More than 90 % of patients with limited-stage and up to 80 % of patients with advanced-stage Hodgkin lymphoma achieve long-term disease-free survival with standard first-line therapies [1]
The purpose of this study was to systematically review and meta-analyze published data on the prognostic value of pretransplant fluoro-2-deoxy-D-glucose positron emission tomography (FDG-PET) in patients with refractory/relapsed Hodgkin lymphoma treated with salvage therapy, highdose therapy (HDT), and autologous stem cell transplantation (SCT)
Search strategy relapsed Hodgkin lymphoma treated with salvage therapy, HDT, and autologous SCT were eligible for inclusion
Summary
More than 90 % of patients with limited-stage and up to 80 % of patients with advanced-stage Hodgkin lymphoma achieve long-term disease-free survival with standard first-line therapies [1]. A non-negligible fraction of Hodgkin lymphoma patients develops refractory/relapsed disease. Randomized trials have demonstrated the potential benefit of salvage chemotherapy followed by consolidation with highdose therapy (HDT) and autologous stem cell transplantation (SCT) as second-line therapy [2, 3]. With this treatment regimen, more than 50 % of patients can be cured [2,3,4,5,6]. Several parameters have proven to be predictive of poor outcome in patients with relapsed Hodgkin lymphoma, including presalvage anemia, hypoalbuminemia, lymphopenia, presence of B symptoms, extranodal involvement at relapse, Ann Hematol (2016) 95:695–706
Sign-in/Register to view highlights & summary 
Published Version (
Free)
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call