Prognostic Value of FDG PET/CT before Allogeneic and Autologous Stem Cell Transplantation for Aggressive Lymphoma

Gary A Ulaner; Debra A Goldman; Craig S Sauter; Jocelyn Migliacci; Joshua Lilienstein; Mithat Gönen; Heiko Schöder; Craig H Moskowitz; Andrew D Zelenetz

doi:10.1148/radiol.2015142556

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Prognostic Value of FDG PET/CT before Allogeneic and Autologous Stem Cell Transplantation for Aggressive Lymphoma

Journal article

Open access

Peer reviewed

Prognostic Value of FDG PET/CT before Allogeneic and Autologous Stem Cell Transplantation for Aggressive Lymphoma

Gary A Ulaner, Debra A Goldman, Craig S Sauter, Jocelyn Migliacci, Joshua Lilienstein, Mithat Gönen, Heiko Schöder, Craig H Moskowitz and Andrew D Zelenetz

Radiology, Vol.277(2), pp.518-526

2015-11

DOI: https://doi.org/10.1148/radiol.2015142556

PMCID: PMC5006668

PMID: 26035588

Abstract

Adolescent

Adult

Aged

Child

Female

Fluorodeoxyglucose F18

Humans

Lymphoma, Non-Hodgkin - diagnostic imaging

Lymphoma, Non-Hodgkin - pathology

Lymphoma, Non-Hodgkin - therapy

Male

Middle Aged

Multimodal Imaging

Positron-Emission Tomography

Prognosis

Radiography

Radiopharmaceuticals

Retrospective Studies

Stem Cell Transplantation

Survival Rate

Treatment Outcome

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. 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. 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. 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.

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Collaboration types: Domestic collaboration
Citation topics: 1 Clinical & Life Sciences; 1.130 Lymphomas; 1.130.132 Lymphoma
Web Of Science research areas: Radiology, Nuclear Medicine & Medical Imaging
ESI research areas: Clinical Medicine

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Title: Prognostic Value of FDG PET/CT before Allogeneic and Autologous Stem Cell Transplantation for Aggressive Lymphoma
Creators: Gary A Ulaner - From the Departments of Radiology (G.A.U., J.L., H.S.), Epidemiology and Biostatistics (D.A.G., M.G.), and Medicine (C.S.S., J.M., C.H.M., A.D.Z.), Memorial Sloan-Kettering Cancer Center, 1275 York Ave, New York, NY 10065; and Departments of Radiology (G.A.U., H.S.) and Medicine (C.S.S., C.H.M., A.D.Z.), Weill Cornell Medical College, New York, NY
Debra A Goldman - From the Departments of Radiology (G.A.U., J.L., H.S.), Epidemiology and Biostatistics (D.A.G., M.G.), and Medicine (C.S.S., J.M., C.H.M., A.D.Z.), Memorial Sloan-Kettering Cancer Center, 1275 York Ave, New York, NY 10065; and Departments of Radiology (G.A.U., H.S.) and Medicine (C.S.S., C.H.M., A.D.Z.), Weill Cornell Medical College, New York, NY
Craig S Sauter - From the Departments of Radiology (G.A.U., J.L., H.S.), Epidemiology and Biostatistics (D.A.G., M.G.), and Medicine (C.S.S., J.M., C.H.M., A.D.Z.), Memorial Sloan-Kettering Cancer Center, 1275 York Ave, New York, NY 10065; and Departments of Radiology (G.A.U., H.S.) and Medicine (C.S.S., C.H.M., A.D.Z.), Weill Cornell Medical College, New York, NY
Jocelyn Migliacci - From the Departments of Radiology (G.A.U., J.L., H.S.), Epidemiology and Biostatistics (D.A.G., M.G.), and Medicine (C.S.S., J.M., C.H.M., A.D.Z.), Memorial Sloan-Kettering Cancer Center, 1275 York Ave, New York, NY 10065; and Departments of Radiology (G.A.U., H.S.) and Medicine (C.S.S., C.H.M., A.D.Z.), Weill Cornell Medical College, New York, NY
Joshua Lilienstein - From the Departments of Radiology (G.A.U., J.L., H.S.), Epidemiology and Biostatistics (D.A.G., M.G.), and Medicine (C.S.S., J.M., C.H.M., A.D.Z.), Memorial Sloan-Kettering Cancer Center, 1275 York Ave, New York, NY 10065; and Departments of Radiology (G.A.U., H.S.) and Medicine (C.S.S., C.H.M., A.D.Z.), Weill Cornell Medical College, New York, NY
Mithat Gönen - From the Departments of Radiology (G.A.U., J.L., H.S.), Epidemiology and Biostatistics (D.A.G., M.G.), and Medicine (C.S.S., J.M., C.H.M., A.D.Z.), Memorial Sloan-Kettering Cancer Center, 1275 York Ave, New York, NY 10065; and Departments of Radiology (G.A.U., H.S.) and Medicine (C.S.S., C.H.M., A.D.Z.), Weill Cornell Medical College, New York, NY
Heiko Schöder - From the Departments of Radiology (G.A.U., J.L., H.S.), Epidemiology and Biostatistics (D.A.G., M.G.), and Medicine (C.S.S., J.M., C.H.M., A.D.Z.), Memorial Sloan-Kettering Cancer Center, 1275 York Ave, New York, NY 10065; and Departments of Radiology (G.A.U., H.S.) and Medicine (C.S.S., C.H.M., A.D.Z.), Weill Cornell Medical College, New York, NY
Craig H Moskowitz - From the Departments of Radiology (G.A.U., J.L., H.S.), Epidemiology and Biostatistics (D.A.G., M.G.), and Medicine (C.S.S., J.M., C.H.M., A.D.Z.), Memorial Sloan-Kettering Cancer Center, 1275 York Ave, New York, NY 10065; and Departments of Radiology (G.A.U., H.S.) and Medicine (C.S.S., C.H.M., A.D.Z.), Weill Cornell Medical College, New York, NY
Andrew D Zelenetz - From the Departments of Radiology (G.A.U., J.L., H.S.), Epidemiology and Biostatistics (D.A.G., M.G.), and Medicine (C.S.S., J.M., C.H.M., A.D.Z.), Memorial Sloan-Kettering Cancer Center, 1275 York Ave, New York, NY 10065; and Departments of Radiology (G.A.U., H.S.) and Medicine (C.S.S., C.H.M., A.D.Z.), Weill Cornell Medical College, New York, NY
Publication Details: Radiology, Vol.277(2), pp.518-526
Grant note: P30 CA008748 / NCI NIH HHS
Academic Unit: Miller School of Medicine; UMMG Department of Medicine
Language: English
Resource Type: Journal article
PMID: 26035588
PMCID: PMC5006668
Record Identifier: 991031613808402976