B-cell lymphoma: surveillance PET after stem cell transplant can detect relapse

  • Savani, M et al.
  • Biol Blood Marrow Transplant
  • 24 Oct 2019

  • curated by David Reilly
  • Univadis Clinical Summaries
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Takeaway

  • In patients with relapsed/refractory diffuse large B-cell lymphoma (R/R DLBCL), surveillance 18F-fluorodeoxyglucose (18F-FDG) positron emission tomography/computed tomography (PET/CT) at day +100 after autologous hematopoietic cell transplantation (AHCT), researchers detected asymptomatic relapse in approximately one-third of patients.
  • High peak standardized uptake value (SUVmax) at day +100 PET was linked to inferior survival.

Why this matters

  • PET/CT has already demonstrated value in identifying patients with DLBCL at high risk for treatment failure before AHCT and in predicting long-term clinical outcomes.

Study design

  • Study to investigate the value of surveillance 18F-FDG PET/CT at day +100 after AHCT in 91 patients with DLBCL.
  • Median age at transplant, 60 (range, 19-73) years.
  • All patients received PET/CT at a median of 44 (range, 32-55) days before AHCT.
  • Funding: None disclosed.

Key results

  • 60 relapse/progression events were observed; 35% were detected with day +100 imaging.
  • 76% of patients did not experience B symptoms at the time of post-AHCT relapse.
  • 4-fold higher risk for overall mortality in patients with post-AHCT Deauville score of 5 vs 1 (HR, 4.10; 95% CI, 1.56-10.77; P≤.01).
  • Mortality risk increased with each doubling of SUVmax (HR, 1.7; 95% CI, 1.3-2.3; P≤.01).

Limitations

  • Single-center retrospective analysis.