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F‐18 FDG‐PET predicts outcomes for patients receiving total lymphoid irradiation and autologous blood stem‐cell transplantation for relapsed and refractory Hodgkin lymphoma |
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| Authors: | Ryan D Gentzler Andrew M Evens Alfred W Rademaker Bing B Weitner Bharat B Mittal Gary L Dillehay Adam M Petrich Jessica K Altman Olga Frankfurt Daina Variakojis Seema Singhal Jayesh Mehta Stephanie Williams Lynne Kaminer Leo I Gordon Jane N Winter |
| Institution: | 1. Division of Hematology/Oncology and the Robert H. Lurie Comprehensive Cancer Center, Northwestern University Feinberg School of Medicine, , Chicago, IL, USA;2. Division of Hematology/Oncology, The University of Massachusetts Medical School, , Worcester, MA, USA;3. Department of Preventive Medicine and the Robert H. Lurie Comprehensive Cancer Center, Northwestern University Feinberg School of Medicine, , Chicago, IL, USA;4. Department of Radiation Oncology and the Robert H. Lurie Comprehensive Cancer Center, Northwestern University Feinberg School of Medicine, , Chicago, IL, USA;5. Department of Radiology and the Robert H. Lurie Comprehensive Cancer Center, Northwestern University Feinberg School of Medicine, , Chicago, IL, USA;6. Department of Pathology and the Robert H. Lurie Comprehensive Cancer Center, Northwestern University Feinberg School of Medicine, , Chicago, IL, USA;7. Spectrum Health Medical Group, Adult Blood and Marrow Transplant Program, , Grand Rapids, MI, USA;8. NorthShore Medical Group, , Evanston, IL, USA |
| Abstract: | Total lymphoid irradiation (TLI) followed by high‐dose chemotherapy and autologous haematopoietic stem cell transplant (aHSCT) is an effective strategy for patients with relapsed/refractory classical Hodgkin lymphoma (HL). We report outcomes for patients with relapsed/refractory HL who received TLI followed by high‐dose chemotherapy and aHSCT. Pre‐transplant fludeoxyglucose positron emission tomography (FDG‐PET) studies were scored on the 5‐point Deauville scale. Of 51 patients treated with TLI and aHSCT, 59% had primary refractory disease and 63% had active disease at aHSCT. The 10‐year progression‐free survival (PFS) and overall survival (OS) for all patients was 56% and 54%, respectively. Patients with complete response (CR) by PET prior to aHSCT had a 5‐year PFS and OS of 85% and 100% compared to 52% and 48% for those without CR (P = 0·09 and P = 0·007, respectively). TLI and aHSCT yields excellent disease control and long‐term survival rates for patients with relapsed/refractory HL, including those with high‐risk disease features. Achievement of CR with salvage therapy is a powerful predictor of outcome. |
| Keywords: | Hodgkin lymphoma radiotherapy chemotherapy positron emission tomography stem cell transplant |