Prognostic significance of FDG-PET in relapsed or refractory classical hodgkin lymphoma treated with standard salvage chemotherapy and autologous stem cell transplantation

Jacob P. Smeltzer; Amanda F. Cashen; Qin Zhang; Andrew Homb; Farrokh Dehdashti; Camille N. Abboud; John F. DiPersio; Keith E. Stockerl-Goldstein; Geoffrey L. Uy; Ravi Vij; Peter Westervelt; Nancy L. Bartlett; Todd A. Fehniger

doi:10.1016/j.bbmt.2011.04.011

Prognostic significance of FDG-PET in relapsed or refractory classical hodgkin lymphoma treated with standard salvage chemotherapy and autologous stem cell transplantation

Jacob P. Smeltzer, Amanda F. Cashen, Qin Zhang, Andrew Homb, Farrokh Dehdashti, Camille N. Abboud, John F. DiPersio, Keith E. Stockerl-Goldstein, Geoffrey L. Uy, Ravi Vij, Peter Westervelt, Nancy L. Bartlett, Todd A. Fehniger

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Abstract

Positron emission tomography using [ ¹⁸F]fluorodeoxyglucose (FDG-PET) has emerged as the standard response assessment tool in frontline therapy for classical Hodgkin lymphoma (cHL). The ability of FDG-PET to predict outcomes in patients with relapsed cHL treated with modern standard salvage chemotherapy and autologous stem cell transplantation (ASCT) remains uncertain. Forty-six patients with relapsed/refractory cHL treated from 2001 to 2007 with standard salvage/ASCT therapy had FDG-PET available for blinded review. The results of pre-ASCT FDG-PET interpreted by the international harmonization project (IHP) criteria were compared with published prognostic models for prediction of event-free survival (EFS) and overall survival (OS). Overall, 3-year EFS was 62% and OS was 78%, with a median follow-up of 38 months. Pre-ASCT FDG-PET response significantly predicted 3-year EFS in FDG-PET-negative (82%) versus FDG-PET-positive (41%) patients (P = .02). A trend was observed for 3-year OS comparing FDG-PET-negative (91%) versus -positive (64%) patients (P = .08). Multivariate analysis demonstrated the independent prognostic significance of pre-ASCT FDG-PET for EFS with a hazard ratio (HR) of 3.2 (confidence interval [CI] 1.1-9.0, P = .03). Pre-ASCT FDG-PET scans predict EFS in patients with relapsed cHL patients treated with modern salvage/ASCT therapy and warrant prospective evaluation.

Original language	English
Pages (from-to)	1646-1652
Number of pages	7
Journal	Biology of Blood and Marrow Transplantation
Volume	17
Issue number	11
DOIs	https://doi.org/10.1016/j.bbmt.2011.04.011
State	Published - Nov 2011

Keywords

Autologous stem cell transplantation
Classical Hodgkin lymphoma
FDG-PET
Prognosis

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10.1016/j.bbmt.2011.04.011

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Smeltzer, J. P., Cashen, A. F., Zhang, Q., Homb, A., Dehdashti, F., Abboud, C. N., DiPersio, J. F., Stockerl-Goldstein, K. E., Uy, G. L., Vij, R., Westervelt, P., Bartlett, N. L., & Fehniger, T. A. (2011). Prognostic significance of FDG-PET in relapsed or refractory classical hodgkin lymphoma treated with standard salvage chemotherapy and autologous stem cell transplantation. Biology of Blood and Marrow Transplantation, 17(11), 1646-1652. https://doi.org/10.1016/j.bbmt.2011.04.011

@article{3c58453dfbb844d498488a9938f13519,

title = "Prognostic significance of FDG-PET in relapsed or refractory classical hodgkin lymphoma treated with standard salvage chemotherapy and autologous stem cell transplantation",

abstract = "Positron emission tomography using [ 18F]fluorodeoxyglucose (FDG-PET) has emerged as the standard response assessment tool in frontline therapy for classical Hodgkin lymphoma (cHL). The ability of FDG-PET to predict outcomes in patients with relapsed cHL treated with modern standard salvage chemotherapy and autologous stem cell transplantation (ASCT) remains uncertain. Forty-six patients with relapsed/refractory cHL treated from 2001 to 2007 with standard salvage/ASCT therapy had FDG-PET available for blinded review. The results of pre-ASCT FDG-PET interpreted by the international harmonization project (IHP) criteria were compared with published prognostic models for prediction of event-free survival (EFS) and overall survival (OS). Overall, 3-year EFS was 62% and OS was 78%, with a median follow-up of 38 months. Pre-ASCT FDG-PET response significantly predicted 3-year EFS in FDG-PET-negative (82%) versus FDG-PET-positive (41%) patients (P = .02). A trend was observed for 3-year OS comparing FDG-PET-negative (91%) versus -positive (64%) patients (P = .08). Multivariate analysis demonstrated the independent prognostic significance of pre-ASCT FDG-PET for EFS with a hazard ratio (HR) of 3.2 (confidence interval [CI] 1.1-9.0, P = .03). Pre-ASCT FDG-PET scans predict EFS in patients with relapsed cHL patients treated with modern salvage/ASCT therapy and warrant prospective evaluation.",

keywords = "Autologous stem cell transplantation, Classical Hodgkin lymphoma, FDG-PET, Prognosis",

author = "Smeltzer, {Jacob P.} and Cashen, {Amanda F.} and Qin Zhang and Andrew Homb and Farrokh Dehdashti and Abboud, {Camille N.} and DiPersio, {John F.} and Stockerl-Goldstein, {Keith E.} and Uy, {Geoffrey L.} and Ravi Vij and Peter Westervelt and Bartlett, {Nancy L.} and Fehniger, {Todd A.}",

note = "Funding Information: This work was supported in part by funding from the Division of Oncology and the Mentors in Medicine program , Division of Medical Education, Department of Internal Medicine at Washington University School of Medicine. This study utilized the Biostatistics Core of the Siteman Cancer Center, funded via the NCI CCC Support Grant P30 CA091842 . This work has been previously presented at the American Society of Hematology Meeting in 2009, abstract number 3417. ",

year = "2011",

month = nov,

doi = "10.1016/j.bbmt.2011.04.011",

language = "English",

volume = "17",

pages = "1646--1652",

journal = "Biology of Blood and Marrow Transplantation",

issn = "1083-8791",

number = "11",

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Smeltzer, JP, Cashen, AF, Zhang, Q, Homb, A, Dehdashti, F , Abboud, CN , DiPersio, JF , Stockerl-Goldstein, KE , Uy, GL , Vij, R, Westervelt, P, Bartlett, NL & Fehniger, TA 2011, 'Prognostic significance of FDG-PET in relapsed or refractory classical hodgkin lymphoma treated with standard salvage chemotherapy and autologous stem cell transplantation', Biology of Blood and Marrow Transplantation, vol. 17, no. 11, pp. 1646-1652. https://doi.org/10.1016/j.bbmt.2011.04.011

Prognostic significance of FDG-PET in relapsed or refractory classical hodgkin lymphoma treated with standard salvage chemotherapy and autologous stem cell transplantation. / Smeltzer, Jacob P.; Cashen, Amanda F.; Zhang, Qin et al.
In: Biology of Blood and Marrow Transplantation, Vol. 17, No. 11, 11.2011, p. 1646-1652.

Research output: Contribution to journal › Article › peer-review

TY - JOUR

T1 - Prognostic significance of FDG-PET in relapsed or refractory classical hodgkin lymphoma treated with standard salvage chemotherapy and autologous stem cell transplantation

AU - Smeltzer, Jacob P.

AU - Cashen, Amanda F.

AU - Zhang, Qin

AU - Homb, Andrew

AU - Dehdashti, Farrokh

AU - Abboud, Camille N.

AU - DiPersio, John F.

AU - Stockerl-Goldstein, Keith E.

AU - Uy, Geoffrey L.

AU - Vij, Ravi

AU - Westervelt, Peter

AU - Bartlett, Nancy L.

AU - Fehniger, Todd A.

N1 - Funding Information: This work was supported in part by funding from the Division of Oncology and the Mentors in Medicine program , Division of Medical Education, Department of Internal Medicine at Washington University School of Medicine. This study utilized the Biostatistics Core of the Siteman Cancer Center, funded via the NCI CCC Support Grant P30 CA091842 . This work has been previously presented at the American Society of Hematology Meeting in 2009, abstract number 3417.

PY - 2011/11

Y1 - 2011/11

N2 - Positron emission tomography using [ 18F]fluorodeoxyglucose (FDG-PET) has emerged as the standard response assessment tool in frontline therapy for classical Hodgkin lymphoma (cHL). The ability of FDG-PET to predict outcomes in patients with relapsed cHL treated with modern standard salvage chemotherapy and autologous stem cell transplantation (ASCT) remains uncertain. Forty-six patients with relapsed/refractory cHL treated from 2001 to 2007 with standard salvage/ASCT therapy had FDG-PET available for blinded review. The results of pre-ASCT FDG-PET interpreted by the international harmonization project (IHP) criteria were compared with published prognostic models for prediction of event-free survival (EFS) and overall survival (OS). Overall, 3-year EFS was 62% and OS was 78%, with a median follow-up of 38 months. Pre-ASCT FDG-PET response significantly predicted 3-year EFS in FDG-PET-negative (82%) versus FDG-PET-positive (41%) patients (P = .02). A trend was observed for 3-year OS comparing FDG-PET-negative (91%) versus -positive (64%) patients (P = .08). Multivariate analysis demonstrated the independent prognostic significance of pre-ASCT FDG-PET for EFS with a hazard ratio (HR) of 3.2 (confidence interval [CI] 1.1-9.0, P = .03). Pre-ASCT FDG-PET scans predict EFS in patients with relapsed cHL patients treated with modern salvage/ASCT therapy and warrant prospective evaluation.

AB - Positron emission tomography using [ 18F]fluorodeoxyglucose (FDG-PET) has emerged as the standard response assessment tool in frontline therapy for classical Hodgkin lymphoma (cHL). The ability of FDG-PET to predict outcomes in patients with relapsed cHL treated with modern standard salvage chemotherapy and autologous stem cell transplantation (ASCT) remains uncertain. Forty-six patients with relapsed/refractory cHL treated from 2001 to 2007 with standard salvage/ASCT therapy had FDG-PET available for blinded review. The results of pre-ASCT FDG-PET interpreted by the international harmonization project (IHP) criteria were compared with published prognostic models for prediction of event-free survival (EFS) and overall survival (OS). Overall, 3-year EFS was 62% and OS was 78%, with a median follow-up of 38 months. Pre-ASCT FDG-PET response significantly predicted 3-year EFS in FDG-PET-negative (82%) versus FDG-PET-positive (41%) patients (P = .02). A trend was observed for 3-year OS comparing FDG-PET-negative (91%) versus -positive (64%) patients (P = .08). Multivariate analysis demonstrated the independent prognostic significance of pre-ASCT FDG-PET for EFS with a hazard ratio (HR) of 3.2 (confidence interval [CI] 1.1-9.0, P = .03). Pre-ASCT FDG-PET scans predict EFS in patients with relapsed cHL patients treated with modern salvage/ASCT therapy and warrant prospective evaluation.

KW - Autologous stem cell transplantation

KW - Classical Hodgkin lymphoma

KW - FDG-PET

KW - Prognosis

UR - http://www.scopus.com/inward/record.url?scp=80054859358&partnerID=8YFLogxK

U2 - 10.1016/j.bbmt.2011.04.011

DO - 10.1016/j.bbmt.2011.04.011

M3 - Article

C2 - 21601641

AN - SCOPUS:80054859358

SN - 1083-8791

VL - 17

SP - 1646

EP - 1652

JO - Biology of Blood and Marrow Transplantation

JF - Biology of Blood and Marrow Transplantation

IS - 11

ER -

Prognostic significance of FDG-PET in relapsed or refractory classical hodgkin lymphoma treated with standard salvage chemotherapy and autologous stem cell transplantation

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