Prognostic role of PET scanning before and after reduced-intensity allogeneic stem cell transplantation for lymphoma.

Abstract:

:Allogeneic stem cell transplantation (SCT) is an established therapy for patients with relapsed lymphoma, but the role of positron emission tomography (PET) scanning preallogeneic and postallogeneic SCT is uncertain. We investigated whether pretransplantation PET status predicted outcome after allogeneic SCT and whether PET surveillance after transplantation provided additional information compared with computed tomography (CT) scanning. Eighty consecutive patients with lymphoma who received a reduced-intensity allogeneic SCT were entered onto a prospective trial. PET and CT scans were performed before transplantation and up to 36 months after transplantation. Forty-two patients were PET-positive before transplantation. Pretransplantation PET status had no significant impact on either relapse rate or overall survival. Thirty-four relapses were observed, of which 17 were PET-positive with a normal CT scan at relapse. Donor lymphocyte infusion (DLI) was administered in 26 episodes of relapse and was guided by PET alone in 14 patients. These findings suggest that, in contrast to autologous SCT, pretransplantation PET status is not predictive of relapse and survival after allogeneic SCT for lymphoma. Posttransplantation surveillance by PET detected relapse before CT in half of episodes, often allowing earlier administration of DLI in patients with recurrent lymphoma, and permitted withholding of potentially harmful DLI in those with PET-negative masses on CT scans.

journal_name

Blood

journal_title

Blood

authors

Lambert JR,Bomanji JB,Peggs KS,Thomson KJ,Chakraverty RK,Fielding AK,Kottaridis PD,Roughton M,Morris EC,Goldstone AH,Linch DC,Ell PJ,Mackinnon S

doi

10.1182/blood-2009-11-255182

subject

Has Abstract

pub_date

2010-04-08 00:00:00

pages

2763-8

issue

14

eissn

0006-4971

issn

1528-0020

pii

blood-2009-11-255182

journal_volume

115

pub_type

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