Prognostic value of pre-transplantation total metabolic tumor volume on 18fluoro-2-deoxy-d-glucose positron emission tomography–computed tomography in relapsed and refractory aggressive lymphoma

Relapsed and refractory aggressive lymphoma have a poor prognosis. High-dose chemotherapy followed by autologous hematopoietic stem cell transplantation (auto-HSCT) is effective in chemosensitive patients. Allogeneic hematopoietic stem cell transplantation (allo-HSCT) is among the few options for no...

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Published in:International journal of hematology 2022-10, Vol.116 (4), p.603-611
Main Authors: Sugio, Takeshi, Baba, Shingo, Mori, Yasuo, Yoshimoto, Goichi, Kamesaki, Kenjiro, Takashima, Shuichiro, Urata, Shingo, Shima, Takahiro, Miyawaki, Kohta, Kikushige, Yoshikane, Kunisaki, Yuya, Numata, Akihiko, Takenaka, Katsuto, Iawasaki, Hiromi, Miyamoto, Toshihiro, Ishigami, Kousei, Akashi, Koichi, Kato, Koji
Format: Article
Language:English
Subjects:
Allografts
Chemotherapy
Computed tomography
Decision making
Emission analysis
Glucose
Hematology
Hematopoietic stem cells
Lymphoma
Medical prognosis
Medicine
Medicine & Public Health
Metabolism
Oncology
Original Article
Positron emission
Positron emission tomography
Prognosis
Stem cell transplantation
Stem cells
Survival
Tomography
Transplantation
Tumors
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Summary:Relapsed and refractory aggressive lymphoma have a poor prognosis. High-dose chemotherapy followed by autologous hematopoietic stem cell transplantation (auto-HSCT) is effective in chemosensitive patients. Allogeneic hematopoietic stem cell transplantation (allo-HSCT) is among the few options for non-chemosensitive patients. 18 Fluoro-2-deoxy- d -glucose positron emission tomography–computed tomography ( 18 FDG-PET/CT) is the standard tool for evaluating response to chemotherapy and residual tumor volume. However, accurate assessment of residual tumor volume is not currently being achieved in clinical practice, and its value in prognostic and therapeutic stratification remains unclear. To answer this question, we investigated the efficacy of quantitative indicators, including total metabolic tumor volume (TMTV), in predicting prognosis after auto-HSCT and allo-HSCT. We retrospectively analyzed 39 patients who received auto-HSCT and 28 who received allo-HSCT. In the auto-HSCT group, patients with a higher TMTV had a poor prognosis due to greater risk of relapse. In the allo-HSCT group, patients with a higher TMTV had a lower progression-free survival rate and a significantly higher relapse rate. Neither Deauville score nor other clinical parameters were associated with prognosis in either group. Therefore, pre-transplant TMTV on PET is effective for prognostic prediction and therapeutic decision-making for relapsed or refractory aggressive lymphoma.
ISSN:0925-5710
1865-3774
DOI:10.1007/s12185-022-03394-w