Improved Survival for Relapsed Diffuse Large B Cell Lymphoma Is Predicted by a Negative Pre-Transplant FDG-PET Scan Following Salvage Chemotherapy

Br J Haematol. 2010 Jul;150(1):39-45. doi: 10.1111/j.1365-2141.2010.08162.x. Epub 2010 May 7.

Abstract

The utility of ([18F])fluoro-2-deoxy- d-glucose positron-emission tomography (FDG-PET) for predicting outcome after autologous stem cell transplantation (ASCT) for diffuse large B cell lymphoma (DLBCL) is uncertain - existing studies include a range of histological subtypes or have a limited duration of follow-up. Thirty-nine patients with primary-refractory or relapsed DLBCL with pre-ASCT PET scans were analysed. The median follow-up was 3 years. The 3-year progression-free survival (PFS) for patients with positive PET scans pre-ASCT was 35% vs. 81% for those who had negative PET scans (P = 0.003). The overall survival (OS) in these groups was 39% and 81% (P = 0.01), respectively. In a multivariate analysis, PET result, number of salvage cycles and the presence of relapsed or refractory disease were shown to predict a longer PFS; PET negativity (P = 0.04) was predictive of a longer OS. PET is useful for defining those with an excellent prognosis post-ASCT. Although those with positive scans can still be salvaged with current treatments, PET may useful for selecting patients eligible for novel consolidation strategies after salvage therapies.

Publication types

  • Multicenter Study
  • Review

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Antineoplastic Combined Chemotherapy Protocols / therapeutic use*
  • Epidemiologic Methods
  • Female
  • Fluorodeoxyglucose F18
  • Humans
  • Lymphoma, Large B-Cell, Diffuse / diagnostic imaging*
  • Lymphoma, Large B-Cell, Diffuse / drug therapy
  • Male
  • Middle Aged
  • Patient Selection
  • Peripheral Blood Stem Cell Transplantation / methods*
  • Positron-Emission Tomography / methods
  • Prognosis
  • Radiopharmaceuticals
  • Recurrence
  • Salvage Therapy / methods
  • Treatment Outcome
  • Young Adult

Substances

  • Radiopharmaceuticals
  • Fluorodeoxyglucose F18