Abstract
We examined the role of fluorodeoxyglucose-positron emission tomography (FDG-PET) and the addition of involved field radiotherapy (IFRT) as potential modifiers of salvage therapy. From January 2000 to June 2007, 83 patients with chemosensitive relapsed or primary refractory diffuse large B-cell lymphoma (DLBCL) underwent FDG-PET scans following second-line chemotherapy before high-dose therapy with autologous stem cell rescue (HDT/ASCR). We evaluated the prognostic value of having a negative FDG-PET scan before HDT/ASCR and whether IFRT improved the outcomes. Median follow-up was 45 months, and the 3-year PFS, disease-specific survival (DSS) and OS were 72, 80 and 78%, respectively. Multivariate analysis revealed that a positive FDG-PET scan had worse PFS (hazard ratio = (HR) 3.4; P = 0.014), DSS (HR = 7.7; P = 0.001) and OS (HR = 5.4; P = 0.001), and that patients not receiving IFRT had worse PFS (HR = 2.7; P = 0.03) and DSS (HR = 2.8, P = 0.059). Patients who received IFRT had better local control with fewer relapses within prior involved sites compared with those that did not receive IFRT (P = 0.006). These outcomes confirm the important prognostic value of FDG-PET scans before undergoing HDT/ASCR. It also suggests that the role of IFRT should be evaluated further.
| Original language | English (US) |
|---|---|
| Pages (from-to) | 941-948 |
| Number of pages | 8 |
| Journal | Bone Marrow Transplantation |
| Volume | 43 |
| Issue number | 12 |
| DOIs | |
| State | Published - Jan 13 2009 |
| Externally published | Yes |
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ASJC Scopus subject areas
- Hematology
- Transplantation
Cite this
The role of FDG-PET imaging and involved field radiotherapy in relapsed or refractory diffuse large B-cell lymphoma. / Hoppe, B. S.; Moskowitz, Craig; Zhang, Z.; Maragulia, J. C.; Rice, R. D.; Reiner, A. S.; Hamlin, P. A.; Zelenetz, A. D.; Yahalom, J.
In: Bone Marrow Transplantation, Vol. 43, No. 12, 13.01.2009, p. 941-948.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - The role of FDG-PET imaging and involved field radiotherapy in relapsed or refractory diffuse large B-cell lymphoma
AU - Hoppe, B. S.
AU - Moskowitz, Craig
AU - Zhang, Z.
AU - Maragulia, J. C.
AU - Rice, R. D.
AU - Reiner, A. S.
AU - Hamlin, P. A.
AU - Zelenetz, A. D.
AU - Yahalom, J.
PY - 2009/1/13
Y1 - 2009/1/13
N2 - We examined the role of fluorodeoxyglucose-positron emission tomography (FDG-PET) and the addition of involved field radiotherapy (IFRT) as potential modifiers of salvage therapy. From January 2000 to June 2007, 83 patients with chemosensitive relapsed or primary refractory diffuse large B-cell lymphoma (DLBCL) underwent FDG-PET scans following second-line chemotherapy before high-dose therapy with autologous stem cell rescue (HDT/ASCR). We evaluated the prognostic value of having a negative FDG-PET scan before HDT/ASCR and whether IFRT improved the outcomes. Median follow-up was 45 months, and the 3-year PFS, disease-specific survival (DSS) and OS were 72, 80 and 78%, respectively. Multivariate analysis revealed that a positive FDG-PET scan had worse PFS (hazard ratio = (HR) 3.4; P = 0.014), DSS (HR = 7.7; P = 0.001) and OS (HR = 5.4; P = 0.001), and that patients not receiving IFRT had worse PFS (HR = 2.7; P = 0.03) and DSS (HR = 2.8, P = 0.059). Patients who received IFRT had better local control with fewer relapses within prior involved sites compared with those that did not receive IFRT (P = 0.006). These outcomes confirm the important prognostic value of FDG-PET scans before undergoing HDT/ASCR. It also suggests that the role of IFRT should be evaluated further.
AB - We examined the role of fluorodeoxyglucose-positron emission tomography (FDG-PET) and the addition of involved field radiotherapy (IFRT) as potential modifiers of salvage therapy. From January 2000 to June 2007, 83 patients with chemosensitive relapsed or primary refractory diffuse large B-cell lymphoma (DLBCL) underwent FDG-PET scans following second-line chemotherapy before high-dose therapy with autologous stem cell rescue (HDT/ASCR). We evaluated the prognostic value of having a negative FDG-PET scan before HDT/ASCR and whether IFRT improved the outcomes. Median follow-up was 45 months, and the 3-year PFS, disease-specific survival (DSS) and OS were 72, 80 and 78%, respectively. Multivariate analysis revealed that a positive FDG-PET scan had worse PFS (hazard ratio = (HR) 3.4; P = 0.014), DSS (HR = 7.7; P = 0.001) and OS (HR = 5.4; P = 0.001), and that patients not receiving IFRT had worse PFS (HR = 2.7; P = 0.03) and DSS (HR = 2.8, P = 0.059). Patients who received IFRT had better local control with fewer relapses within prior involved sites compared with those that did not receive IFRT (P = 0.006). These outcomes confirm the important prognostic value of FDG-PET scans before undergoing HDT/ASCR. It also suggests that the role of IFRT should be evaluated further.
UR - http://www.scopus.com/inward/record.url?scp=67649884048&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=67649884048&partnerID=8YFLogxK
U2 - 10.1038/bmt.2008.408
DO - 10.1038/bmt.2008.408
M3 - Article
C2 - 19139730
AN - SCOPUS:67649884048
VL - 43
SP - 941
EP - 948
JO - Bone Marrow Transplantation
JF - Bone Marrow Transplantation
SN - 0268-3369
IS - 12
ER -