Pretransplantation Functional Imaging Predicts Outcome Following Autologous Stem Cell Transplantation for Relapsed and Refractory Hodgkin Lymphoma

Overview

Journal Blood

Publisher Elsevier

Specialty Hematology

Date 2010 Aug 25

PMID 20733154

Citations 90

Authors

Alison J Moskowitz

Joachim Yahalom

Tarun Kewalramani

Jocelyn C Maragulia

Jill M Vanak

Andrew D Zelenetz

Craig H Moskowitz

Affiliations

Soon will be listed here.

Abstract

To identify prognostic factors for patients transplanted for relapsed or refractory Hodgkin lymphoma we carried out a combined analysis of patients followed prospectively on 3 consecutive protocols at Memorial Sloan-Kettering Cancer Center. One hundred fifty-three patients with chemosensitive disease after ICE (ifosfamide, carboplatin, and etoposide)-based salvage therapy (ST) proceeded to high-dose chemoradiotherapy followed by autologous stem cell transplantation (ASCT). Patients were evaluated with computed tomography and functional imaging (gallium or fluorodeoxyglucose-positron emission tomography) prior to ST and again before ASCT. Functional imaging status before ASCT was the only factor significant for event-free survival (EFS) and overall survival by multivariate analysis and clearly identifies poor risk patients (5-year EFS 31% and 75% for FI-positive and negative patients respectively). Administration of involved-field radiotherapy with ASCT was marginally significant for EFS (P = .055). Studies evaluating novel STs, conditioning regimens, post-ASCT maintenance, or allogeneic stem cell transplantation are warranted for patients who fail to normalize pre-ASCT functional imaging.

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References

Gallamini A, Hutchings M, Rigacci L, Specht L, Merli F, Hansen M . Early interim 2-[18F]fluoro-2-deoxy-D-glucose positron emission tomography is prognostically superior to international prognostic score in advanced-stage Hodgkin's lymphoma: a report from a joint Italian-Danish study. J Clin Oncol. 2007; 25(24):3746-52. DOI: 10.1200/JCO.2007.11.6525. View

Moskowitz C, Nimer S, Zelenetz A, Trippett T, Hedrick E, Filippa D . A 2-step comprehensive high-dose chemoradiotherapy second-line program for relapsed and refractory Hodgkin disease: analysis by intent to treat and development of a prognostic model. Blood. 2001; 97(3):616-23. DOI: 10.1182/blood.v97.3.616. View

Schmitz N, Pfistner B, Sextro M, Sieber M, Carella A, Haenel M . Aggressive conventional chemotherapy compared with high-dose chemotherapy with autologous haemopoietic stem-cell transplantation for relapsed chemosensitive Hodgkin's disease: a randomised trial. Lancet. 2002; 359(9323):2065-71. DOI: 10.1016/S0140-6736(02)08938-9. View

Becherer A, Mitterbauer M, Jaeger U, Kalhs P, Greinix H, Karanikas G . Positron emission tomography with [18F]2-fluoro-D-2-deoxyglucose (FDG-PET) predicts relapse of malignant lymphoma after high-dose therapy with stem cell transplantation. Leukemia. 2002; 16(2):260-7. DOI: 10.1038/sj.leu.2402342. View

Escobar I, Caballero Barrigon D, Tamayo P, Perez-Simon J, Mateos M, Garcia J . Prognostic impact of pretransplantation computed tomography and gallium scans in patients with Hodgkin lymphoma with poor prognosis undergoing hematopoietic stem cell transplantation. Clin Lymphoma Myeloma. 2007; 7(3):217-25. DOI: 10.3816/CLM.2006.n.062. View

Linch D, Winfield D, Goldstone A, Moir D, Hancock B, McMillan A . Dose intensification with autologous bone-marrow transplantation in relapsed and resistant Hodgkin's disease: results of a BNLI randomised trial. Lancet. 1993; 341(8852):1051-4. DOI: 10.1016/0140-6736(93)92411-l. View

Goodman K, Riedel E, Serrano V, Gulati S, Moskowitz C, Yahalom J . Long-term effects of high-dose chemotherapy and radiation for relapsed and refractory Hodgkin's lymphoma. J Clin Oncol. 2008; 26(32):5240-7. DOI: 10.1200/JCO.2007.15.5507. View

Schot B, Zijlstra J, Sluiter W, van Imhoff G, Pruim J, Vaalburg W . Early FDG-PET assessment in combination with clinical risk scores determines prognosis in recurring lymphoma. Blood. 2006; 109(2):486-91. DOI: 10.1182/blood-2005-11-006957. View

Moskowitz C, Yahalom J, Zelenetz A, Zhang Z, Filippa D, Teruya-Feldstein J . High-dose chemo-radiotherapy for relapsed or refractory Hodgkin lymphoma and the significance of pre-transplant functional imaging. Br J Haematol. 2010; 148(6):890-7. PMC: 3920913. DOI: 10.1111/j.1365-2141.2009.08037.x. View

10.

Crocchiolo R, Canevari C, Assanelli A, Lunghi F, Tassara M, Stanghellini M . Pre-transplant 18FDG-PET predicts outcome in lymphoma patients treated with high-dose sequential chemotherapy followed by autologous stem cell transplantation. Leuk Lymphoma. 2008; 49(4):727-33. DOI: 10.1080/10428190701885545. View

11.

Spaepen K, Stroobants S, Dupont P, Vandenberghe P, Maertens J, Bormans G . Prognostic value of pretransplantation positron emission tomography using fluorine 18-fluorodeoxyglucose in patients with aggressive lymphoma treated with high-dose chemotherapy and stem cell transplantation. Blood. 2003; 102(1):53-9. DOI: 10.1182/blood-2002-12-3842. View

12.

Hutchings M, Loft A, Hansen M, Moller Pedersen L, Buhl T, Jurlander J . FDG-PET after two cycles of chemotherapy predicts treatment failure and progression-free survival in Hodgkin lymphoma. Blood. 2005; 107(1):52-9. DOI: 10.1182/blood-2005-06-2252. View

13.

Jabbour E, Hosing C, Ayers G, Nunez R, Anderlini P, Pro B . Pretransplant positive positron emission tomography/gallium scans predict poor outcome in patients with recurrent/refractory Hodgkin lymphoma. Cancer. 2007; 109(12):2481-9. DOI: 10.1002/cncr.22714. View

14.

Sirohi B, Cunningham D, Powles R, Murphy F, Arkenau T, Norman A . Long-term outcome of autologous stem-cell transplantation in relapsed or refractory Hodgkin's lymphoma. Ann Oncol. 2008; 19(7):1312-1319. DOI: 10.1093/annonc/mdn052. View