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Pretransplant FDG ‐ PET in aggressive non‐Hodgkin lymphoma: systematic review and meta‐analysis
Author(s) -
Adams Hugo J. A.,
Kwee Thomas C.
Publication year - 2017
Publication title -
european journal of haematology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.904
H-Index - 84
eISSN - 1600-0609
pISSN - 0902-4441
DOI - 10.1111/ejh.12837
Subject(s) - medicine , lymphoma , meta analysis , oncology , aggressive lymphoma , confounding , hodgkin lymphoma , publication bias , rituximab
This study aimed to systematically review and meta‐analyze the value of pretransplant FDG ‐ PET in predicting outcome after autologous stem cell transplantation in aggressive non‐Hodgkin lymphoma. MEDLINE was systematically searched; included studies were methodologically assessed and meta‐analyzed, when possible. Overall methodological quality of included studies ( n = 11) was poor, with moderate risk of bias in the domains of study participation ( n = 7) and prognostic factor measurement ( n = 7), and high risk of bias in the domains of outcome measurement ( n = 10), and study confounding ( n = 11). In all aggressive non‐Hodgkin lymphomas, pooled sensitivity and specificity were 54.0% and 73.1% in predicting treatment failure, and 54.5% and 68.7% in predicting death. Because of interstudy heterogeneity, additional subgroup analyses were performed. In newly diagnosed aggressive non‐Hodgkin lymphoma, pooled sensitivity and specificity were 20.0% and 70.0% in predicting treatment failure, and 8.3% % and 30.5% in predicting death. In refractory/relapsed aggressive non‐Hodgkin lymphoma, pooled sensitivity and specificity were 68.1% and 72.1% in predicting treatment failure, and 77.3% and 69.6% in predicting death. At present, pretransplant FDG ‐ PET cannot be recommended in aggressive non‐Hodgkin lymphoma, because available studies suffer from major methodological flaws, and reported prognostic estimates are low (i.e., poor in newly diagnosed and moderate in refractory/relapsed aggressive non‐Hodgkin lymphoma).