Open AccessPB1998 PROGNOSTIC VALUE OF PRETRANSPLANT PET/CT IN HODGKIN LYMPHOMA
Author(s) -
Dr Miltényi Z.,
Punk E.,
Dr Pinczés L.I.,
Illés Á.
Publication year - 2019
Publication title -
hemasphere
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.677
H-Index - 11
ISSN - 2572-9241
DOI - 10.1097/01.hs9.0000566484.04063.77
Subject(s) - medicine , lymphoma , pet ct , hodgkin lymphoma , nuclear medicine , positron emission tomography , radiology
Background: Autologous stem cell transplant (ASCT) is the standard of treatment in patients with refractory/relapsed Hodgkin lymphoma (HL). Several adverse prognostic factors at relapse are known (stage, anaemia, B signs, Karnofsky score, early relapse etc.) to predict the outcome after ASCT. Aims: We analyzed the prognostic value of pre‐ transplant PET/CT and number of salvage therapy retrospectively. Methods: Between January 1, 2007 and December 31, 2018 pre‐transplantation 18 FDG‐PET/CT scans of Hodgkin‐lymphoma patients were performed. Deauville criteria were used for evaluation of PET/CT scans. Positive PET scans were defined, if Deauville score was 4 or 5. We analyzed the effect of PET/CT results for survival (overall‐, relapse‐ and event free), and investigated differences between PET positive and PET negative groups. Statistical analysis was performed using IBM SPSS 25 programme. Results: Sixty‐two Hodgkin‐lymphoma patients (33 men and 29 women) had PET/CT scan before AHSCT. Median age at the time of AHSCT was 35 (19‐65) years. Median follow up time was 55.4 (0‐175) months. There were 49 (79%) PET negative and 13 (21%) PET positive patients. Five‐year overall survival rate was 80% in PET‐ group, and 46.2 % in PET+ group (p < 0.042). Five‐year relapse‐free and event‐free survival rate for negative and positive groups were 85.5% and 43.5% (p < 0.012), and 70.3% and 30.8% (p < 0.006). There were 6 relapse and 9 deaths (3 due to HL) in PET‐ group, and 5 relapse and 6 deaths (due to HL) in PET+ group. Twenty‐five of 49 patients in the PET‐ group got only one type of salvage treatment (DHAP) before AHSCT, against 2 of 13 patients in PET+ group (p = 0.046). Patients who acquired PET negative status after DHAP therapy only, had no relapse. Patients who were treated with 2 or more lines of salvage therapy and acquired PET negative status after these treatments, has no significantly better relapse‐free survival, than patients who remained PET positive. Summary/Conclusion: C linical routine use of PET/CT before AHSCT is highly suggested based on our investigation. PET‐ patients have significantly better OS, PFS and EFS. PET negative status attends better prognosis, if it is reached with first salvage treatment.