Impact of Pretransplantation F-fluorodeoxy Glucose-Positron Emission Tomography Status on Outcomes after Allogeneic Hematopoietic Cell Transplantation for Non-Hodgkin Lymphoma Journal Article


Authors: Bachanova, V; Burns, L. J.; Ahn, K. W.; Laport, G. G.; Akpek, G; Kharfan-Dabaja, M. A.; Nishihori, T; Agura, E; Armand, P.; Jaglowski, S. M.; Cairo, M. S.; Cashen, A. F.; Cohen, J. B.; D'Souza, A; Freytes, C. O.; Gale, R. P.; Ganguly, S; Ghosh, N; Holmberg, L. A.; Inwards, D. J.; Kanate, A. S.; Lazarus, H. M.; Malone, A. K.; Munker, R; Mussetti, A; Norkin, M.; Prestidge, T. D.; Rowe, J. M.; Satwani, P.; Siddiqi, T; Stiff, P. J.; William, B. M.; Wirk, B; Maloney, D. G.; Smith, S. M.; Sureda, A. M.; Carreras, J; Hamadani, M; for Center for International Blood and Marrow Transplant Research Lymphoma Working Committee
Article Title: Impact of Pretransplantation F-fluorodeoxy Glucose-Positron Emission Tomography Status on Outcomes after Allogeneic Hematopoietic Cell Transplantation for Non-Hodgkin Lymphoma
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 worse OS (RR, 1.29, 95% confidence interval [CI], .96 to 1.7; P = .08), PFS (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.
Keywords: non-Hodgkin lymphoma; Allogeneic transplantation; Positron emission tomography
Journal Title: Biology of blood and marrow transplantation : journal of the American Society for Blood and Marrow Transplantation
Volume: 21
Issue: 9
ISSN: 1523-6536; 1083-8791
Publisher: Elsevier Inc  
Date Published: 2015
Start Page: 1605
End Page: 1611
Language: ENG
DOI/URL:
Notes: LR: 20150610; CI: Copyright (c) 2015; GR: U01 HL069294/HL/NHLBI NIH HHS/United States; GR: U10 HL069294/HL/NHLBI NIH HHS/United States; GR: U24 CA076518/CA/NCI NIH HHS/United States; JID: 9600628; OTO: NOTNLM; 2015/02/17 [received]; 2015/05/06 [accepted]; aheadofprint