Pretransplantation positron emission tomography scan is the main predictor of autologous stem cell transplantation outcome in aggressive B-cell non-Hodgkin lymphoma

Enrico Derenzini, Gerardo Musuraca, Stefano Fanti, Vittorio Stefoni, Monica Tani, Lapo Alinari, Filippo Venturini, Letizia Gandolfi, Michele Baccarani, Pier Luigi Zinzani

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Abstract

BACKGROUND. Limited data exist about the role of second-line chemotherapy response assessed by positron emission tomography (PET) as a prognostic factor in patients with aggressive non-Hodgkin Lymphoma (NHL) who undergo autologous stem cell transplantation (ASCT). The objective of this analysis was to investigate the main determinants of prognosis in patients with aggressive B-cell NHL who undergo ASCT, focusing on the impact of pretransplantation PET, secondary age-adjusted International Prognostic Index (sAA-IPI) score, histology, and previous response to first-line chemotherapy. METHODS. Seventy-five patients with diffuse, large B-cell lymphoma or grade 3 follicular lymphoma who were treated at the author' institution with second-line chemotherapy (combined ifosfamide, etoposide, and epirubicin [IEV]) followed by ASCT between September 2002 and September 2006 were included. All patients were evaluated by PET after 1 to 3 courses of IEV chemotherapy before ASCT, and all patients received a conditioning regimen of combined carmustine, etoposide, cytosine arabinoside, and melphalan. The prognostic impact of pretransplantation PET, sAA-IPI score, histology, and previous response to first-line chemotherapy was evaluated by univariate and multivariate analyses. RESULTS. Seventy-two of 75 patients underwent ASCT. In a univariate analysis for progression-free survival (PFS) and overall survival (OS), a significant association was observed with pretransplantation PET (PFS, P <.00001; OS, P <.01) and previous first-line response (PFS, P = .02; OS, P = .04). In the multivariate framework, pretransplantation PET was identified as the only independent prognostic factor (PFS, P <.001; OS, P = .01). CONCLUSIONS. The current data indicated that pretransplantation PET is the main prognostic predictor in patients with aggressive B-cell NHL who are scheduled for ASCT.

Original languageEnglish
Pages (from-to)2496-2503
Number of pages8
JournalCancer
Volume113
Issue number9
DOIs
Publication statusPublished - Nov 1 2008

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Keywords

  • Autologous stem cell transplantation
  • Diffuse large B-cell lymphoma
  • Follicular lymphoma
  • Positron emission tomography
  • Progression-free survival
  • Secondary age-adjusted International Prognostic Index

ASJC Scopus subject areas

  • Cancer Research
  • Oncology

Cite this

Derenzini, E., Musuraca, G., Fanti, S., Stefoni, V., Tani, M., Alinari, L., Venturini, F., Gandolfi, L., Baccarani, M., & Zinzani, P. L. (2008). Pretransplantation positron emission tomography scan is the main predictor of autologous stem cell transplantation outcome in aggressive B-cell non-Hodgkin lymphoma. Cancer, 113(9), 2496-2503. https://doi.org/10.1002/cncr.23861