Document Detail


Pretransplantation positron emission tomography scan is the main predictor of autologous stem cell transplantation outcome in aggressive B-cell non-Hodgkin lymphoma.
MedLine Citation:
PMID:  18833583     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Limited data exist about the role of second-line chemotherapy response assessed by positron emission tomography (PET) as a prognostic factor in patients with aggressive non-Hodgkin Lymphoma (NHL) who undergo autologous stem cell transplantation (ASCT). The objective of this analysis was to investigate the main determinants of prognosis in patients with aggressive B-cell NHL who undergo ASCT, focusing on the impact of pretransplantation PET, secondary age-adjusted International Prognostic Index (sAA-IPI) score, histology, and previous response to first-line chemotherapy. METHODS: Seventy-five patients with diffuse, large B-cell lymphoma or grade 3 follicular lymphoma who were treated at the author' institution with second-line chemotherapy (combined ifosfamide, etoposide, and epirubicin [IEV]) followed by ASCT between September 2002 and September 2006 were included. All patients were evaluated by PET after 1 to 3 courses of IEV chemotherapy before ASCT, and all patients received a conditioning regimen of combined carmustine, etoposide, cytosine arabinoside, and melphalan. The prognostic impact of pretransplantation PET, sAA-IPI score, histology, and previous response to first-line chemotherapy was evaluated by univariate and multivariate analyses. RESULTS: Seventy-two of 75 patients underwent ASCT. In a univariate analysis for progression-free survival (PFS) and overall survival (OS), a significant association was observed with pretransplantation PET (PFS, P< .00001; OS, P< .01) and previous first-line response (PFS, P= .02; OS, P= .04). In the multivariate framework, pretransplantation PET was identified as the only independent prognostic factor (PFS, P< .001; OS, P= .01). CONCLUSIONS: The current data indicated that pretransplantation PET is the main prognostic predictor in patients with aggressive B-cell NHL who are scheduled for ASCT.
Authors:
Enrico Derenzini; Gerardo Musuraca; Stefano Fanti; Vittorio Stefoni; Monica Tani; Lapo Alinari; Filippo Venturini; Letizia Gandolfi; Michele Baccarani; Pier Luigi Zinzani
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Publication Detail:
Type:  Clinical Trial; Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Cancer     Volume:  113     ISSN:  0008-543X     ISO Abbreviation:  Cancer     Publication Date:  2008 Nov 
Date Detail:
Created Date:  2008-10-27     Completed Date:  2008-11-24     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0374236     Medline TA:  Cancer     Country:  United States    
Other Details:
Languages:  eng     Pagination:  2496-503     Citation Subset:  AIM; IM    
Affiliation:
Institute of Hematology and Medical Oncology L. & A. Seràgnoli, University of Bologna, Bologna, Italy. enrico.derenzini@libero.it
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Antineoplastic Combined Chemotherapy Protocols / therapeutic use*
Carmustine / administration & dosage
Cyclophosphamide / administration & dosage
Cytarabine / administration & dosage
Etoposide / administration & dosage
Female
Fluorodeoxyglucose F18 / diagnostic use
Hematopoietic Stem Cell Transplantation*
Humans
Ifosfamide / administration & dosage
Lymphoma, Follicular / pathology,  radionuclide imaging,  therapy
Lymphoma, Large B-Cell, Diffuse / pathology,  radionuclide imaging*,  therapy*
Male
Melphalan / administration & dosage
Middle Aged
Positron-Emission Tomography*
Predictive Value of Tests
Prognosis
Prospective Studies
Radiopharmaceuticals / diagnostic use
Remission Induction
Salvage Therapy
Survival Analysis
Transplantation, Autologous
Vincristine / administration & dosage
Chemical
Reg. No./Substance:
0/Radiopharmaceuticals; 147-94-4/Cytarabine; 148-82-3/Melphalan; 154-93-8/Carmustine; 33419-42-0/Etoposide; 3778-73-2/Ifosfamide; 50-18-0/Cyclophosphamide; 57-22-7/Vincristine; 63503-12-8/Fluorodeoxyglucose F18

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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