Pre-Transplantation FDG-PET Predicts Early but Not Late Survival Outcomes Following Allogeneic Transplantation in Chemo-Sensitive Hodgkin Lymphoma
| Autor: | Stephen Mackinnon, Emma C. Morris, Nigel H. Russell, Christopher P. Fox, Adele K. Fielding, Mark Bishton, Ronjon Chakraverty, Irfan Kayani, Ben Taylor, Adrian Bloor, Karl S. Peggs, Kirsty Thomson, Yasmin Reyal |
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| Rok vydání: | 2014 |
| Předmět: |
Oncology
medicine.medical_specialty Allogeneic transplantation business.industry Immunology Context (language use) Cell Biology Hematology medicine.disease Biochemistry Surgery Lymphoma Transplantation Autologous stem-cell transplantation Internal medicine Cohort medicine Progression-free survival business Progressive disease |
| Zdroj: | Blood. 124:1225-1225 |
| ISSN: | 1528-0020 0006-4971 |
| Popis: | Positron emission tomography (PET) is increasingly employed both to guide response-adjusted therapeutic strategies and to provide prognostic information in patients with Hodgkin Lymphoma (HL). The presence of residual [18-F]FDG-avid lesions prior to autologous stem cell transplantation (ASCT) confers a poor prognosis in terms of relapse risk and event-free survival outcomes, even when analysis is restricted to those with chemo-sensitive disease. The prognostic power of PET in the setting of allogeneic SCT remains more contentious, with relatively little data currently published. Information is particularly sparse in terms of outcomes relating to specific histological subtypes of lymphoma. We identified 160 patients transplanted for HL at four UK transplant centers using T-cell depleted conditioning regimens, based either on fludarabine-melphalan-alemtuzumab (FM-C) or the BCNU-etoposide-cytarabine-melphalan-alemtuzumab (BEAM-C) backbone, in whom pre-transplantation PET data were available. These represent the primary data set. Median age was 30 (12-66) years; 59 had failed a prior ASCT and these patients more commonly received FM-C (56/59 vs 26/101, p In summary, these data from a large cohort of patients with HL undergoing T-cell depleted allogeneic SCT illustrate inferior outcomes in those with progressive disease prior to transplantation, an altered kinetic of relapse and early survival advantage for those with Deauville 1-2 PET scores compared to those with non-progressive Deauville 3-5 PET scores, but no statistically significant differences in longer term outcomes including relapse risk, PFS and OS. Importantly, these data suggest that the allogeneic graft-versus-tumor activity likely overcomes the poor prognostic impact that has been demonstrated with residual metabolically active disease in the context of conventional dose escalation and ASCT, supporting further exploration of response-adjusted transplantation algorithms. Figure 1 Figure 1. Disclosures No relevant conflicts of interest to declare. |
| Databáze: | OpenAIRE |
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