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
Notes: Export Date: 2 December 2015 -- Source: Scopus
Citation Impact
MSK Authors
  1. Gary Ulaner
    144 Ulaner
  2. Craig Moskowitz
    406 Moskowitz
  3. Mithat Gonen
    946 Gonen
  4. Heiko Schoder
    480 Schoder
  5. Craig Steven Sauter
    330 Sauter
  6. Andrew D Zelenetz
    722 Zelenetz
  7. Jocelyn C Migliacci
    104 Migliacci
  8. Debra Alyssa Goldman
    154 Goldman