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Publication Detail
Impact of Pretransplantation 18F-Fluorodeoxyglucose-Positron Emission Tomography on Survival Outcomes after T Cell-Depleted Allogeneic Transplantation for Hodgkin Lymphoma
  • Publication Type:
    Journal article
  • Publication Sub Type:
    Article
  • Authors:
    Reyal Y, Kayani I, Bloor AJC, Fox CP, Chakraverty R, Sjursen AM, Fielding AK, Ben Taylor M, Bishton MJ, Morris EC, Thomson KJ, Russell N, Mackinnon S, Peggs KS
  • Publication date:
    14/04/2016
  • Pagination:
    1234, 1241
  • Journal:
    Biology of Blood and Marrow Transplantation
  • Volume:
    22
  • Issue:
    7
  • Status:
    Published
  • Print ISSN:
    1083-8791
Abstract
© 2016 American Society for Blood and Marrow Transplantation.Pretransplant 18F-fluorodeoxyglucose (FDG) positron emission tomography status is an important prognostic factor for outcomes after autologous stem cell transplantation (SCT) in Hodgkin lymphoma (HL), but its impact on outcomes after allogeneic SCT remains unclear. We retrospectively evaluated outcomes after T cell-depleted allogeneic SCT of 116 patients with nonprogressive HL according to pretransplant Deauville scores. Endpoints were overall survival (OS), progression-free survival (PFS), relapse rate (RR), and nonrelapse-related mortality (NRM). OS, PFS, and RR did not differ significantly between the Deauville 1 to 2 and Deauville 3 to 5 cohorts (OS: 77.5% versus 67.3%, P = 49; PFS: 59.4% versus 55.7%, P = 43; RR: 20.9% versus 22.6%, P = 28 at 4 years). Differences in PFS remained statistically nonsignificant when comparisons were made between Deauville 1 to 3 and Deauville 4 to 5 cohorts (60.9% versus 51.4%, P = 10), and RR remained very similar (21.5% versus 23.8%, P = 42). Multivariate analyses demonstrated trends toward significance for an effect of Deauville score on PFS (hazard ratio 1.82 for Deauville 4 to 5, P = 06) and for number of lines of prior therapy on OS (hazard ratio 2.34 for >5 lines, P = 10). The latter effect appeared to be driven by higher NRM rather than increased RR. Our findings suggest that Deauville score before allogeneic SCT in patients with nonprogressive HL has a relatively modest impact on survival outcomes in comparison with the impact in autologous SCT and that predictive values for the individual patient remain low, indicating that residual FDG-avid disease should not preclude allogeneic SCT. Furthermore, our findings bring into question the importance of attainment of metabolic complete response in this setting if it is at the expense of increasing NRM risk.
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Research Department of Haematology
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Research Department of Haematology
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Div of Infection & Immunity
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Research Department of Haematology
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