Focal skeletal FDG uptake indicates poor prognosis in cHL regardless of extent and first-line chemotherapy
| Autor: | Lars C. Gormsen, Maja D. Andersen, Daniel Molin, Cecilia Wassberg, Alexander Lindholm d'Amore, Sally F. Barrington, Gunilla Enblad, Rose-Marie Amini, Francesco d'Amore, Peter Kamper, Peter Johnson, Stephen Hamilton-Dutoit, Mette Abildgaard Pedersen |
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| Jazyk: | angličtina |
| Rok vydání: | 2019 |
| Předmět: |
Adult
Male BEACOPP medicine.medical_specialty Vincristine Adolescent Cyclophosphamide medicine.medical_treatment Dacarbazine Bone Neoplasms Procarbazine chemotherapy bone marrow uptake Disease-Free Survival Young Adult 03 medical and health sciences 0302 clinical medicine focal bone lesions Bone Marrow Fluorodeoxyglucose F18 Positron Emission Tomography Computed Tomography Antineoplastic Combined Chemotherapy Protocols medicine Humans Aged Retrospective Studies Aged 80 and over Sweden Chemotherapy business.industry F-FDG PET/CT Hematology Middle Aged Hodgkin Disease Chemotherapy regimen Treatment Outcome classical Hodgkin lymphoma ABVD 030220 oncology & carcinogenesis Female Radiology Radiopharmaceuticals business 030215 immunology medicine.drug |
| Zdroj: | Pedersen, M A, Gormsen, L C, Kamper, P, Wassberg, C, Andersen, M D, d'Amore, A L, Barrington, S F, Johnson, P, Hamilton-Dutoit, S, Amini, R M, Enblad, G, Molin, D & d'Amore, F 2019, ' Focal skeletal FDG uptake indicates poor prognosis in cHL regardless of extent and first-line chemotherapy ', British Journal of Haematology, vol. 186, no. 3, pp. 431-439 . https://doi.org/10.1111/bjh.15933 Pedersen, M A, Gormsen, L C, Kamper, P, Wassberg, C, Andersen, M D, d'Amore, A L, Barrington, S F, Johnson, P, Hamilton-Dutoit, S, Amini, R M, Enblad, G, Molin, D & d'Amore, F 2019, ' Focal skeletal FDG uptake indicates poor prognosis in cHL regardless of extent and first-line chemotherapy ' British Journal of Haematology . https://doi.org/10.1111/bjh.15933 |
| Popis: | 18F-fluoro-2-deoxy-D-glucose positron emission tomography/computed tomography (FDG-PET/CT) is used for staging classical Hodgkin lymphoma (cHL) with high sensitivity for skeletal involvement. However, it is unclear whether a single bone lesion carries the same adverse prognosis as multifocal lesions and if this is affected by type of chemotherapy [ABVD (adriamycin, bleomycin, vincristine, dacarbazine) versus BEACOPP (bleomycin, etoposide, adriamycin, cyclophosphamide, vincristine, procarbazine, prednisone)]. We reviewed the clinico-pathological and outcome data from 209 patients with newly diagnosed cHL staged by FDG-PET/CT. Patterns of skeletal/bone marrow uptake (BMU) were divided into ‘low’ and ‘high’ diffuse BMU (i.e. without focal lesions), and unifocal or multifocal lesions. Additional separate survival analysis was performed, taking type of chemotherapy into account. Forty patients (19·2%) had skeletal lesions (20 unifocal, 20 multifocal). The 3-year progression-free-survival (PFS) was 80% for patients with ‘low BMU’, 87% for ‘high BMU’, 69% for ‘unifocal’ and 51% for ‘multifocal’ lesions; median follow-up was 38 months. The presence of bone lesions, both uni- and multifocal, was associated with significantly inferior PFS (log rank P = 0·0001), independent of chemotherapy type. Thus, increased diffuse BMU should not be considered as a risk factor in cHL, whereas unifocal or multifocal bone lesions should be regarded as important predictors of adverse outcome, irrespective of the chemotherapy regimen used. |
| Databáze: | OpenAIRE |
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