Early interim 2-[18F]fluoro-2-deoxy-D-glucose positron emission tomography is prognostically superior to international prognostic score in advanced-stage Hodgkin's lymphoma: A report from a joint Italian-Danish study

Andrea Gallamini, Martin Hutchings, Luigi Rigacci, Lena Specht, Francesco Merli, Mads Hansen, Caterina Patti, Annika Loft, Francesco Di Raimondo, Francesco D'Amore, Alberto Biggi, Umberto Vitolo, Caterina Stelitano, Rosario Sancetta, Livio Trentin, Stefano Luminari, Emilio Iannitto, Simonetta Viviani, Ivana Pierri, Alessandro Levis

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Abstract

Purpose: Starting from November 2001, 260 newly diagnosed patients with Hodgkin's lymphoma (HL) were consecutively enrolled in parallel Italian and Danish prospective trials to evaluate the prognostic role of an early interim 2-[18F]fluoro-2-deoxy-D-glucose positron emission tomography (FDG-PET) scan and the International Prognostic Score (IPS) in advanced HL, treated with conventional ABVD (doxorubicin, bleomycin, vinblastine, and dacarbazine) therapy. Patients and Methods: Most patients (n = 190) presented with advanced disease (stages IIB through IVB), whereas 70 presented in stage IIA with adverse prognostic factors. All but 11 patients were treated with standard ABVD therapy followed by consolidation radiotherapy in case of bulky presentation or residual tumor mass. Conventional radiologic staging was performed at baseline. FDG-PET scan was performed at baseline and after two courses of ABVD (PET-2). No treatment change was allowed on the basis of the PET-2 results. Results: After a median follow-up of 2.19 years (range, 0.32 to 5.18 years), 205 patients were in continued complete remission and two patients were in partial remission. Forty-three patients progressed during therapy or immediately after, whereas 10 patients relapsed. The 2-year progression-free survival for patients with positive PET-2 results was 12.8% and for patients with negative PET-2 results was 95.0% (P <.0001). In univariate analysis, the treatment outcome was significantly associated with PET-2 (P <.0001), stage IV (P <.0001), WBC more than 15,000 (P <.0001), lymphopenia (P <.001), IPS as a continuous variable (P <.0001), extranodal involvement (P <.0001), and bulky disease (P = .012). In multivariate analyses, only PET-2 turned out to be significant (P <.0001). Conclusion: PET-2 overshadows the prognostic value of IPS and emerges as the single most important tool for planning of risk-adapted treatment in advanced HL.

Original languageEnglish
Pages (from-to)3746-3752
Number of pages7
JournalJournal of Clinical Oncology
Volume25
Issue number24
DOIs
Publication statusPublished - Aug 20 2007

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Fluorodeoxyglucose F18
Hodgkin Disease
Positron-Emission Tomography
Therapeutics
Dacarbazine
Lymphopenia
Vinblastine
Bleomycin
Residual Neoplasm
Doxorubicin
Disease-Free Survival
Radiotherapy
Multivariate Analysis

ASJC Scopus subject areas

  • Cancer Research
  • Oncology

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Early interim 2-[18F]fluoro-2-deoxy-D-glucose positron emission tomography is prognostically superior to international prognostic score in advanced-stage Hodgkin's lymphoma : A report from a joint Italian-Danish study. / Gallamini, Andrea; Hutchings, Martin; Rigacci, Luigi; Specht, Lena; Merli, Francesco; Hansen, Mads; Patti, Caterina; Loft, Annika; Di Raimondo, Francesco; D'Amore, Francesco; Biggi, Alberto; Vitolo, Umberto; Stelitano, Caterina; Sancetta, Rosario; Trentin, Livio; Luminari, Stefano; Iannitto, Emilio; Viviani, Simonetta; Pierri, Ivana; Levis, Alessandro.

In: Journal of Clinical Oncology, Vol. 25, No. 24, 20.08.2007, p. 3746-3752.

Research output: Contribution to journalArticle

Gallamini, A, Hutchings, M, Rigacci, L, Specht, L, Merli, F, Hansen, M, Patti, C, Loft, A, Di Raimondo, F, D'Amore, F, Biggi, A, Vitolo, U, Stelitano, C, Sancetta, R, Trentin, L, Luminari, S, Iannitto, E, Viviani, S, Pierri, I & Levis, A 2007, 'Early interim 2-[18F]fluoro-2-deoxy-D-glucose positron emission tomography is prognostically superior to international prognostic score in advanced-stage Hodgkin's lymphoma: A report from a joint Italian-Danish study', Journal of Clinical Oncology, vol. 25, no. 24, pp. 3746-3752. https://doi.org/10.1200/JCO.2007.11.6525
Gallamini, Andrea ; Hutchings, Martin ; Rigacci, Luigi ; Specht, Lena ; Merli, Francesco ; Hansen, Mads ; Patti, Caterina ; Loft, Annika ; Di Raimondo, Francesco ; D'Amore, Francesco ; Biggi, Alberto ; Vitolo, Umberto ; Stelitano, Caterina ; Sancetta, Rosario ; Trentin, Livio ; Luminari, Stefano ; Iannitto, Emilio ; Viviani, Simonetta ; Pierri, Ivana ; Levis, Alessandro. / Early interim 2-[18F]fluoro-2-deoxy-D-glucose positron emission tomography is prognostically superior to international prognostic score in advanced-stage Hodgkin's lymphoma : A report from a joint Italian-Danish study. In: Journal of Clinical Oncology. 2007 ; Vol. 25, No. 24. pp. 3746-3752.
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abstract = "Purpose: Starting from November 2001, 260 newly diagnosed patients with Hodgkin's lymphoma (HL) were consecutively enrolled in parallel Italian and Danish prospective trials to evaluate the prognostic role of an early interim 2-[18F]fluoro-2-deoxy-D-glucose positron emission tomography (FDG-PET) scan and the International Prognostic Score (IPS) in advanced HL, treated with conventional ABVD (doxorubicin, bleomycin, vinblastine, and dacarbazine) therapy. Patients and Methods: Most patients (n = 190) presented with advanced disease (stages IIB through IVB), whereas 70 presented in stage IIA with adverse prognostic factors. All but 11 patients were treated with standard ABVD therapy followed by consolidation radiotherapy in case of bulky presentation or residual tumor mass. Conventional radiologic staging was performed at baseline. FDG-PET scan was performed at baseline and after two courses of ABVD (PET-2). No treatment change was allowed on the basis of the PET-2 results. Results: After a median follow-up of 2.19 years (range, 0.32 to 5.18 years), 205 patients were in continued complete remission and two patients were in partial remission. Forty-three patients progressed during therapy or immediately after, whereas 10 patients relapsed. The 2-year progression-free survival for patients with positive PET-2 results was 12.8{\%} and for patients with negative PET-2 results was 95.0{\%} (P <.0001). In univariate analysis, the treatment outcome was significantly associated with PET-2 (P <.0001), stage IV (P <.0001), WBC more than 15,000 (P <.0001), lymphopenia (P <.001), IPS as a continuous variable (P <.0001), extranodal involvement (P <.0001), and bulky disease (P = .012). In multivariate analyses, only PET-2 turned out to be significant (P <.0001). Conclusion: PET-2 overshadows the prognostic value of IPS and emerges as the single most important tool for planning of risk-adapted treatment in advanced HL.",
author = "Andrea Gallamini and Martin Hutchings and Luigi Rigacci and Lena Specht and Francesco Merli and Mads Hansen and Caterina Patti and Annika Loft and {Di Raimondo}, Francesco and Francesco D'Amore and Alberto Biggi and Umberto Vitolo and Caterina Stelitano and Rosario Sancetta and Livio Trentin and Stefano Luminari and Emilio Iannitto and Simonetta Viviani and Ivana Pierri and Alessandro Levis",
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T1 - Early interim 2-[18F]fluoro-2-deoxy-D-glucose positron emission tomography is prognostically superior to international prognostic score in advanced-stage Hodgkin's lymphoma

T2 - A report from a joint Italian-Danish study

AU - Gallamini, Andrea

AU - Hutchings, Martin

AU - Rigacci, Luigi

AU - Specht, Lena

AU - Merli, Francesco

AU - Hansen, Mads

AU - Patti, Caterina

AU - Loft, Annika

AU - Di Raimondo, Francesco

AU - D'Amore, Francesco

AU - Biggi, Alberto

AU - Vitolo, Umberto

AU - Stelitano, Caterina

AU - Sancetta, Rosario

AU - Trentin, Livio

AU - Luminari, Stefano

AU - Iannitto, Emilio

AU - Viviani, Simonetta

AU - Pierri, Ivana

AU - Levis, Alessandro

PY - 2007/8/20

Y1 - 2007/8/20

N2 - Purpose: Starting from November 2001, 260 newly diagnosed patients with Hodgkin's lymphoma (HL) were consecutively enrolled in parallel Italian and Danish prospective trials to evaluate the prognostic role of an early interim 2-[18F]fluoro-2-deoxy-D-glucose positron emission tomography (FDG-PET) scan and the International Prognostic Score (IPS) in advanced HL, treated with conventional ABVD (doxorubicin, bleomycin, vinblastine, and dacarbazine) therapy. Patients and Methods: Most patients (n = 190) presented with advanced disease (stages IIB through IVB), whereas 70 presented in stage IIA with adverse prognostic factors. All but 11 patients were treated with standard ABVD therapy followed by consolidation radiotherapy in case of bulky presentation or residual tumor mass. Conventional radiologic staging was performed at baseline. FDG-PET scan was performed at baseline and after two courses of ABVD (PET-2). No treatment change was allowed on the basis of the PET-2 results. Results: After a median follow-up of 2.19 years (range, 0.32 to 5.18 years), 205 patients were in continued complete remission and two patients were in partial remission. Forty-three patients progressed during therapy or immediately after, whereas 10 patients relapsed. The 2-year progression-free survival for patients with positive PET-2 results was 12.8% and for patients with negative PET-2 results was 95.0% (P <.0001). In univariate analysis, the treatment outcome was significantly associated with PET-2 (P <.0001), stage IV (P <.0001), WBC more than 15,000 (P <.0001), lymphopenia (P <.001), IPS as a continuous variable (P <.0001), extranodal involvement (P <.0001), and bulky disease (P = .012). In multivariate analyses, only PET-2 turned out to be significant (P <.0001). Conclusion: PET-2 overshadows the prognostic value of IPS and emerges as the single most important tool for planning of risk-adapted treatment in advanced HL.

AB - Purpose: Starting from November 2001, 260 newly diagnosed patients with Hodgkin's lymphoma (HL) were consecutively enrolled in parallel Italian and Danish prospective trials to evaluate the prognostic role of an early interim 2-[18F]fluoro-2-deoxy-D-glucose positron emission tomography (FDG-PET) scan and the International Prognostic Score (IPS) in advanced HL, treated with conventional ABVD (doxorubicin, bleomycin, vinblastine, and dacarbazine) therapy. Patients and Methods: Most patients (n = 190) presented with advanced disease (stages IIB through IVB), whereas 70 presented in stage IIA with adverse prognostic factors. All but 11 patients were treated with standard ABVD therapy followed by consolidation radiotherapy in case of bulky presentation or residual tumor mass. Conventional radiologic staging was performed at baseline. FDG-PET scan was performed at baseline and after two courses of ABVD (PET-2). No treatment change was allowed on the basis of the PET-2 results. Results: After a median follow-up of 2.19 years (range, 0.32 to 5.18 years), 205 patients were in continued complete remission and two patients were in partial remission. Forty-three patients progressed during therapy or immediately after, whereas 10 patients relapsed. The 2-year progression-free survival for patients with positive PET-2 results was 12.8% and for patients with negative PET-2 results was 95.0% (P <.0001). In univariate analysis, the treatment outcome was significantly associated with PET-2 (P <.0001), stage IV (P <.0001), WBC more than 15,000 (P <.0001), lymphopenia (P <.001), IPS as a continuous variable (P <.0001), extranodal involvement (P <.0001), and bulky disease (P = .012). In multivariate analyses, only PET-2 turned out to be significant (P <.0001). Conclusion: PET-2 overshadows the prognostic value of IPS and emerges as the single most important tool for planning of risk-adapted treatment in advanced HL.

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