Prognostic value of FDG PET/CT before allogeneic and autologous stem cell transplantation for aggressive lymphoma Journal Article


Authors: Ulaner, G. A.; Goldman, D. A.; Sauter, C. S.; Migliacci, J.; Lilienstein, J.; Gönen, M.; Schöder, H.; Moskowitz, C. H.; Zelenetz, A. D.
Article Title: Prognostic value of FDG PET/CT before allogeneic and autologous stem cell transplantation for aggressive lymphoma
Abstract: Purpose: To determine the prognostic value of performing fluorine-18 fluorodeoxyglucose (FDG) positron emission tomography (PET)/computed tomography (CT) before allogeneic and autologous stem cell transplantation (SCT) in patients with aggressive lymphoma. Materials and Methods: A HIPAA-compliant retrospective review was performed under institutional review board waiver. Patients with aggressive lymphoma underwent allogeneic or autologous SCT between January 2005 and December 2010. FDG PET/CT was performed within the 3 months prior to transplantation. PET/CT images were evaluated for lesions with FDG avidity greater than that of the background liver. The relationship between pretransplantation PET and progression-free survival (PFS), disease-specific survival (DSS), and overall survival (OS) was assessed with Kaplan-Meier curves and a corresponding log-rank test for categorical variables and Cox regression for continuous variables. Results: A total of 175 patients were identified, of whom 73 underwent FDG PET/CT before allogeneic SCT and 102 underwent FDG PET/CT before autologous SCT. Before allogeneic SCT, 23 of 73 patients (32%) had FDG-avid lesions, and before autologous SCT, 11 of 102 patients (11%) had FDG-avid lesions. For allogeneic SCT, the 2-year PFS estimate was 68% (95% confidence interval [CI]: 56%, 82%) in patients without FDG-avid lesions, but only 35% (95% CI: 20%, 61%) for patients with FDG-avid lesions (P =.014). For autologous SCT, the 2-year PFS was 72% (95% CI: 64%, 82%) in patients without FDG-avid lesions, but only 18% (95% CI: 5%, 64%) for patients with FDG-avid lesions (P <.0001). Similar differences were seen in OS and DSS. The risk for posttransplantation recurrence correlated with higher lesional maximum standardized uptake values: for PFS, P <.0001 to P =.01; for DSS, P <.0001 to P =.002; and for OS, P <.0001 to P =.015. Conclusion: Performing FDG PET/CT before SCT in patients with aggressive lymphoma has prognostic value. For patients with aggressive lymphomas, the presence of FDG-avid lesions at PET/CT performed before allogeneic and autologous SCT indicates a lower likelihood of SCT success. © 2015 RSNA.
Keywords: adolescent; adult; child; controlled study; aged; major clinical study; overall survival; allogeneic stem cell transplantation; cancer recurrence; recurrence risk; progression free survival; autologous stem cell transplantation; retrospective study; risk assessment; lymphoma; fluorodeoxyglucose f 18; computer assisted emission tomography; disease specific survival; cancer prognosis; human; male; female; priority journal; article
Journal Title: Radiology
Volume: 277
Issue: 2
ISSN: 0033-8419
Publisher: Radiological Society of North America, Inc.  
Date Published: 2015-11-01
Start Page: 518
End Page: 526
Language: English
DOI: 10.1148/radiol.2015142556
PROVIDER: scopus
PUBMED: 26035588
PMCID: PMC5006668
DOI/URL:
Notes: Export Date: 2 December 2015 -- Source: Scopus
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MSK Authors
  1. Gary Ulaner
    90 Ulaner
  2. Craig Moskowitz
    378 Moskowitz
  3. Mithat Gonen
    723 Gonen
  4. Heiko Schoder
    293 Schoder
  5. Craig Steven Sauter
    167 Sauter
  6. Andrew D Zelenetz
    563 Zelenetz
  7. Debra Alyssa Goldman
    99 Goldman