Association of pre-transplantation positron emission tomography/computed tomography and outcome in mantle cell lymphoma

• Published in: Bone marrow transplantation (Basingstoke) Vol. 48; no. 9; pp. 1212 - 1217
• Main Authors: Cohen, J B, Hall, N C, Ruppert, A S, Jones, J A, Porcu, P, Baiocchi, R, Christian, B A, Penza, S, Benson, D M, Flynn, J, Andritsos, L A, Devine, S M, Blum, K A
• Format: Journal Article
• Language: English
• Published: London Nature Publishing Group UK 01.09.2013; Nature Publishing Group
• Subjects: 631/250/1904; 692/699/67/1990/291/1621; 692/700/1421; 692/700/1750; Adult; Aged; Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy; Autografts; B-cell lymphoma; Biological and medical sciences; Bone marrow; Bone marrow, stem cells transplantation. Graft versus host reaction; Cell Biology; Computed tomography; Confidence intervals; Diagnosis; Disease-Free Survival; Drug therapy; Female; Health aspects; Hematologic and hematopoietic diseases; Hematology; Hematopoietic Stem Cell Transplantation - methods; Humans; Internal Medicine; Leukemias. Malignant lymphomas. Malignant reticulosis. Myelofibrosis; Lymphocytes B; Lymphoma; Lymphoma, Mantle-Cell - diagnosis; Lymphoma, Mantle-Cell - diagnostic imaging; Lymphoma, Mantle-Cell - surgery; Male; Mantle cell lymphoma; Medical sciences; Medicine; Medicine & Public Health; Middle Aged; Multimodal Imaging - methods; original-article; PET imaging; Positron emission; Positron emission tomography; Positron-Emission Tomography - methods; Prognosis; Public Health; Remission; Retrospective Studies; Stem cell transplantation; Stem Cells; Tomography; Tomography, X-Ray Computed - methods; Transfusions. Complications. Transfusion reactions. Cell and gene therapy; Transplantation; Transplantation Conditioning - methods; Transplantation, Homologous; Transplants & implants; Treatment Outcome; United States; mantle cell lymphoma; non-Hodgkin’s lymphoma; PET and CT; autologous transplantation; SCT; Radionuclide study; Prognosis; Stem cell; Hematopoietic cell; Transplantation; non-Hodgkin's lymphoma; Surgery; Lymphoproliferative syndrome; Autologous hematopoietic stem cell transplantation; Graft; Radiodiagnosis; Hematology; B cell neoplasm; Malignant hemopathy; B-Lymphocyte; Non Hodgkin lymphoma; Treatment; Mantle cell lymphoma; Medical imagery; Computerized axial tomography; Positron emission tomography; Cancer; Emission tomography
• ISSN: 0268-3369; 1476-5365
• DOI: 10.1038/bmt.2013.46

Positron emission tomography/computed tomography (PET/CT)-positive findings before autologous SCT (auto-SCT) are associated with inferior PFS and OS in patients with relapsed Hodgkin’s and diffuse large B-cell lymphoma. We classified pre-transplant PET/CT performed before auto-SCT as positive or negative to evaluate the impact of pre-transplant PET/CT in mantle cell lymphoma (MCL). In 29 patients, 17 were PET/CT(−) and 12 were PET/CT(+). PET/CT(+) patients were younger ( P =0.04), had lower MCL International Prognostic Index (MIPI, P =0.04) scores, but increased bulky adenopathy >5 cm (45% vs 13%, P =0.09). With a median follow-up of 27 months (range: 5–55 months), 7 patients relapsed (4 in the PET/CT(−) group and 3 in the PET/CT(+) group) with 2 deaths in the PET/CT(+) group without a documented relapse. The estimated 2-year PFS was 64% (95% confidence interval (CI): 0.30–0.85) vs 87% (95% CI: 0.57–0.97) in PET/CT(+) and PET/CT(−) patients, respectively ( P =0.054). OS was significantly decreased in PET/CT(+) patients ( P =0.007), with 2-year estimates of 60% (95% CI: 0.23–0.84) vs 100% in PET/CT(−) patients. A positive pre-transplant PET/CT is associated with a poor prognosis in patients with MCL. Additional factors may impact the prognostic value of PET/CT, as several PET/CT(+) patients remain in remission.