[HTML][HTML] Impact of pretransplantation 18f-fluorodeoxy glucose–positron emission tomography status on outcomes after allogeneic hematopoietic cell transplantation for …

V Bachanova, LJ Burns, KW Ahn, GG Laport… - Biology of Blood and …, 2015 - Elsevier
Biology of Blood and Marrow Transplantation, 2015Elsevier
Assessment with 18 F-fluorodeoxy glucose (FDG)–positron emission tomography (PET)
before hematopoietic cell transplantation (HCT) for lymphoma may be prognostic for
outcomes. Patients with chemotherapy-sensitive non–Hodgkin lymphoma (NHL) undergoing
allogeneic HCT reported to the Center of International Blood and Marrow Transplantation
Registry between 2007 and 2012 were included. Pre-HCT PET status (positive versus
negative) was determined by the reporting transplantation centers. We analyzed 336 …
Abstract
Assessment with 18F-fluorodeoxy glucose (FDG)–positron emission tomography (PET) before hematopoietic cell transplantation (HCT) for lymphoma may be prognostic for outcomes. Patients with chemotherapy-sensitive non–Hodgkin lymphoma (NHL) undergoing allogeneic HCT reported to the Center of International Blood and Marrow Transplantation Registry between 2007 and 2012 were included. Pre-HCT PET status (positive versus negative) was determined by the reporting transplantation centers. We analyzed 336 patients; median age was 55 years and 60% were males. Follicular lymphoma (n = 104) was more common than large cell (n = 85), mantle cell (n = 69), and mature natural killer or T cell lymphoma (n = 78); two thirds of the cohort received reduced-intensity conditioning; one half had unrelated donor grafts. Patients underwent PET scanning a median of 1 month (range, .07 to 2.83 months) before HCT; 159 were PET positive and 177 were PET negative. At 3 years, relapse/progression, progression-free survival (PFS), and overall survival (OS) in PET-positive versus PET-negative groups were 40% versus 26%; P = .007; 43% versus 47%; P = .47; and 58% versus 60%; P = .73, respectively. On multivariate analysis, a positive pretransplantation PET was associated with an increased risk of relapse/progression (risk ratio [RR], 1.86; P = .001) but was not associated with increased mortality (RR, 1.29, 95% confidence interval [CI], .96 to 1.7; P = .08), therapy failure (RR, 1.32; 95% CI, .95 to 1.84; P = .10), or nonrelapse mortality (RR, .75; 95% CI, .48 to 1.18; P = .22). PET status conferred no influence on graft-versus-host disease. A positive PET scan before HCT is associated with increased relapse risk but should not be interpreted as a barrier to a successful allograft. PET status does not appear to predict survival after allogeneic HCT for NHL.
Elsevier