Impact of Routine Surveillance Imaging on Outcomes of Patients With Diffuse Large B-Cell Lymphoma After Autologous Hematopoietic Cell Transplantation

Clin Lymphoma Myeloma Leuk. 2016 Dec;16(12):672-678. doi: 10.1016/j.clml.2016.08.018. Epub 2016 Aug 29.


Background: For patients with relapsed or refractory diffuse large B-cell lymphoma (DLBCL), autologous hematopoietic cell transplantation (auto-HCT) is commonly used. After auto-HCT, DLBCL patients are often monitored with surveillance imaging. However, there is little evidence to support this practice.

Patients and methods: We performed a multicenter retrospective study of DLBCL patients who underwent auto-HCT (n = 160), who experienced complete remission after transplantation, and who then underwent surveillance imaging. Of these, only 45 patients experienced relapse after day +100 after auto-HCT, with relapse detected by routine imaging in 32 (71%) and relapse detected clinically in 13 (29%).

Results: Baseline patient characteristics were similar between the 2 groups. Comparing the radiographic and clinically detected relapse groups, the median time from diagnosis to auto-HCT (389 days vs. 621 days, P = .06) and the median follow-up after auto-HCT (2464 days vs. 1593 days P = .60) were similar. The median time to relapse after auto-HCT was 191 days in radiographically detected relapses compared to 492 days in clinically detected relapses (P = .35), and median postrelapse survival was 359 days in such patients compared to 123 days in patients with clinically detected relapse (P = .36). However, the median posttransplantation overall survival was not significantly different for patients with relapse detected by routine imaging versus relapse detected clinically (643 vs. 586 days, P = .68).

Conclusion: A majority (71%) of DLBCL relapses after auto-HCT are detected by routine surveillance imaging. Overall, there appears to be limited utility for routine imaging after auto-HCT except in select cases where earlier detection and salvage therapy with allogeneic HCT is a potential option.

Keywords: Auto-HCT; Clinical; DLBCL; Radiographic; Relapse.

Publication types

  • Multicenter Study

MeSH terms

  • Combined Modality Therapy
  • Diagnostic Imaging* / methods
  • Female
  • Hematopoietic Stem Cell Transplantation / methods
  • Humans
  • Lymphoma, Large B-Cell, Diffuse / diagnostic imaging*
  • Lymphoma, Large B-Cell, Diffuse / mortality
  • Lymphoma, Large B-Cell, Diffuse / therapy
  • Male
  • Monitoring, Physiologic
  • Neoplasm Staging
  • Positron Emission Tomography Computed Tomography
  • Positron-Emission Tomography
  • Postoperative Care
  • Recurrence
  • Retrospective Studies
  • Survival Analysis
  • Time Factors
  • Tomography, X-Ray Computed
  • Transplantation, Autologous
  • Treatment Outcome
  • Workflow