The role of FDG-PET imaging and involved field radiotherapy in relapsed or refractory diffuse large B-cell lymphoma

B. S. Hoppe; C. H. Moskowitz; Z. Zhang; J. C. Maragulia; R. D. Rice; A. S. Reiner; P. A. Hamlin; A. D. Zelenetz; J. Yahalom

doi:10.1038/bmt.2008.408

The role of FDG-PET imaging and involved field radiotherapy in relapsed or refractory diffuse large B-cell lymphoma

B. S. Hoppe, C. H. Moskowitz, Z. Zhang, J. C. Maragulia, R. D. Rice, A. S. Reiner, P. A. Hamlin, A. D. Zelenetz, J. Yahalom

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

40 Scopus citations

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	https://doi.org/10.1038/bmt.2008.408
State	Published - 2009
Externally published	Yes

ASJC Scopus subject areas

Hematology
Transplantation

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The role of FDG-PET imaging and involved field radiotherapy in relapsed or refractory diffuse large B-cell lymphoma. / Hoppe, B. S.; Moskowitz, C. H.; 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, 2009, p. 941-948.

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

@article{96a1cb0fc23742a6ba0690380b90f445,

title = "The role of FDG-PET imaging and involved field radiotherapy in relapsed or refractory diffuse large B-cell lymphoma",

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.",

author = "Hoppe, {B. S.} and Moskowitz, {C. H.} and Z. Zhang and Maragulia, {J. C.} and Rice, {R. D.} and Reiner, {A. S.} and Hamlin, {P. A.} and Zelenetz, {A. D.} and J. Yahalom",

note = "Funding Information: This study was supported from the Lymphoma Foundation and the Sports Foundation against Cancer. BSH, MD, was a Dr Mortimer Lacher 2007 Lymphoma Fellow at the Memorial Sloan-Kettering Cancer Center. We thank Carol Pearce, MFA, writer/editor with the MSKCC Department of Medicine Editorial Unit, for reviewing this manuscript.",

year = "2009",

doi = "10.1038/bmt.2008.408",

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AU - Hoppe, B. S.

AU - Moskowitz, C. H.

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.

N1 - Funding Information: This study was supported from the Lymphoma Foundation and the Sports Foundation against Cancer. BSH, MD, was a Dr Mortimer Lacher 2007 Lymphoma Fellow at the Memorial Sloan-Kettering Cancer Center. We thank Carol Pearce, MFA, writer/editor with the MSKCC Department of Medicine Editorial Unit, for reviewing this manuscript.

PY - 2009

Y1 - 2009

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.

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The role of FDG-PET imaging and involved field radiotherapy in relapsed or refractory diffuse large B-cell lymphoma

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