Impact of Pretransplantation 18F-fluorodeoxy Glucose-Positron Emission Tomography Status on Outcomes after Allogeneic Hematopoietic Cell Transplantation for Non-Hodgkin Lymphoma

Veronika Bachanova, Linda J. Burns, Kwang Woo Ahn, Ginna G. Laport, Görgün Akpek, Mohamed A. Kharfan-Dabaja, Taiga Nishihori, Edward Agura, Philippe Armand, Samantha M. Jaglowski, Mitchell S. Cairo, Amanda F. Cashen, Jonathon B. Cohen, Anita D'Souza, César O. Freytes, Robert Peter Gale, Siddhartha Ganguly, Nilanjan Ghosh, Leona A. Holmberg, David J. InwardsAbraham S. Kanate, Hillard M. Lazarus, Adriana K. Malone, Reinhold Munker, Alberto Mussetti, Maxim Norkin, Tim D. Prestidge, Jacob M. Rowe, Prakash Satwani, Tanya Siddiqi, Patrick J. Stiff, Basem M. William, Baldeep Wirk, David G. Maloney, Sonali M. Smith, Anna M. Sureda, Jeanette Carreras, Mehdi Hamadani

Research output: Contribution to journalArticlepeer-review

Abstract

Assessment with 18F-fluorodeoxy glucose (FDG)-positron emission tomography (PET) before hematopoietic cell transplantation (HCT) for lymphoma may be prognostic for outcomes. Patients with chemotherapy-sensitive non-Hodgkin lymphoma (NHL) undergoing allogeneic HCT reported to the Center of International Blood and Marrow Transplantation Registry between 2007 and 2012 were included. Pre-HCT PET status (positive versus negative) was determined by the reporting transplantation centers. We analyzed 336 patients; median age was 55 years and 60% were males. Follicular lymphoma (n = 104) was more common than large cell (n = 85), mantle cell (n = 69), and mature natural killer or T cell lymphoma (n = 78); two thirds of the cohort received reduced-intensity conditioning; one half had unrelated donor grafts. Patients underwent PET scanning a median of 1 month (range, .07 to 2.83 months) before HCT; 159 were PET positive and 177 were PET negative. At 3 years, relapse/progression, progression-free survival (PFS), and overall survival (OS) in PET-positive versus PET-negative groups were 40% versus 26%; P = .007; 43% versus 47%; P = .47; and 58% versus 60%; P = .73, respectively. On multivariate analysis, a positive pretransplantation PET was associated with an increased risk of relapse/progression (risk ratio [RR], 1.86; P = .001) but was not associated with increased mortality (RR, 1.29, 95% confidence interval [CI], .96 to 1.7; P = .08), therapy failure (RR, 1.32; 95% CI, .95 to 1.84; P = .10), or nonrelapse mortality (RR, .75; 95% CI, .48 to 1.18; P = .22). PET status conferred no influence on graft-versus-host disease. A positive PET scan before HCT is associated with increased relapse risk but should not be interpreted as a barrier to a successful allograft. PET status does not appear to predict survival after allogeneic HCT for NHL.

Original languageEnglish
Pages (from-to)1605-1611
Number of pages7
JournalBiology of Blood and Marrow Transplantation
Volume21
Issue number9
DOIs
Publication statusPublished - Sep 1 2015

Keywords

  • Allogeneic transplantation
  • Non-Hodgkin lymphoma
  • Positron emission tomography

ASJC Scopus subject areas

  • Transplantation
  • Hematology

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