Utility of Routine Surveillance Imaging for Hodgkin Disease following Autologous Transplant: Experiences from a Single Institution

Acta Haematol. 2018;139(1):52-57. doi: 10.1159/000484549. Epub 2018 Jan 17.

Abstract

Background: Surveillance scans performed after autologous stem cell transplant (auto-HCT) for patients with Hodgkin disease (HD) have no proven survival benefit.

Methods: We studied survival differences among patients with HD after auto-HCT whose recurrences were detected on clinical history and exam, versus those detected on routine surveillance scan.

Results: Among the 98 patients with HD that underwent auto-HCT from 2000 to 2014 at our institution, 30 relapsed, of which 21 were detected radiologically and 9 clinically. There were no statistically significant differences in patient characteristics between the 2 groups. The median time to progression was 118 days for the clinical cohort and 284 days for the radiological cohort (p = 0.05). Median overall survival (OS) was 728 days for the clinical cohort, and was not reached for the radiological cohort (p = 0.02).

Discussion: In our review, most patients with HD after auto-HCT were diagnosed radiologically. Patients whose relapse was diagnosed clinically were likely to be detected earlier and have a shorter OS. Patients with aggressive disease may be detected when clinically relevant, regardless of scanning. Routine scanning may not be necessary in the majority of patients with HD following auto-HCT.

Keywords: Autologous stem cell transplant; Hodgkin disease; Surveillance scans; Survival.

MeSH terms

  • Adult
  • Aged
  • Autografts
  • Diagnostic Imaging* / methods
  • Disease Progression
  • Female
  • Follow-Up Studies
  • Hematopoietic Stem Cell Transplantation
  • Hodgkin Disease / diagnosis*
  • Hodgkin Disease / mortality
  • Hodgkin Disease / therapy
  • Humans
  • Kaplan-Meier Estimate
  • Male
  • Middle Aged
  • Retrospective Studies
  • Transplantation, Autologous
  • Watchful Waiting
  • Young Adult