Post-treatment (not interim) positron emission tomography-computed tomography scan status is highly predictive of outcome in mantle cell lymphoma patients treated with R-HyperCVAD

TY - JOUR

T1 - Post-treatment (not interim) positron emission tomography-computed tomography scan status is highly predictive of outcome in mantle cell lymphoma patients treated with R-HyperCVAD

AU - Mato, Anthony R.

AU - Svoboda, Jakub

AU - Feldman, Tatyana

AU - Zielonka, Tania

AU - Agress, Harry

AU - Panush, David

AU - Miller, Mitchell

AU - Toth, Patrick

AU - Lizotte, Paul M.

AU - Nasta, Sunita

AU - Goldberg, Stuart

AU - Chong, Emeline

AU - Schuster, Steven

AU - Pecora, Andrew L.

AU - Goy, Andre

PY - 2012/7/15

Y1 - 2012/7/15

N2 - BACKGROUND: Although convincing data exist regarding the prognostic utility of positron emission tomographic (PET)-computed tomographic (CT) imaging in Hodgkin lymphoma and diffuse large B-cell lymphoma, its prognostic utility both during treatment and immediately after treatment have not been systematically evaluated in a large mantle cell lymphoma (MCL) patient cohort to support its use in clinical practice. METHODS: The authors conducted a retrospective cohort study to examine the prognostic utility of PET-CT imaging in a uniform MCL patient cohort undergoing dose-intensive chemotherapy (R-HyCVAD) in the frontline setting. The primary study endpoints were progression-free survival (PFS) and overall survival (OS). PET-CT images were centrally reviewed for the purposes of this study using standardized response criteria. RESULTS: Fifty-three patients with advanced stage MCL with PET-CT data were identified. With median follow-up of 32 months, 3-year PFS and OS estimates were 76% (95% confidence interval [CI], 64%-84%) and 84% (95% CI, 72%-90%), respectively. Interim PET-CT status was not associated with PFS (hazard ratio [HR], 0.9; 95% CI, 0.3-2.7; P =.8) or OS (HR, 0.6; 95% CI, 0.1-2.9; P =.5). Post-treatment PET-CT status was statistically significantly associated with PFS (HR, 5.2; 95% CI, 2.0-13.6; P =.001) and trended toward significant for OS (HR, 2.8; 95% CI, 0.8-9.6; P =.07). CONCLUSIONS: These data do not support the prognostic utility of PET-CT in pretreatment and interim treatment settings. A positive PET-CT after the completion of therapy identifies a patient subset with an inferior PFS and a trend toward inferior OS.

AB - BACKGROUND: Although convincing data exist regarding the prognostic utility of positron emission tomographic (PET)-computed tomographic (CT) imaging in Hodgkin lymphoma and diffuse large B-cell lymphoma, its prognostic utility both during treatment and immediately after treatment have not been systematically evaluated in a large mantle cell lymphoma (MCL) patient cohort to support its use in clinical practice. METHODS: The authors conducted a retrospective cohort study to examine the prognostic utility of PET-CT imaging in a uniform MCL patient cohort undergoing dose-intensive chemotherapy (R-HyCVAD) in the frontline setting. The primary study endpoints were progression-free survival (PFS) and overall survival (OS). PET-CT images were centrally reviewed for the purposes of this study using standardized response criteria. RESULTS: Fifty-three patients with advanced stage MCL with PET-CT data were identified. With median follow-up of 32 months, 3-year PFS and OS estimates were 76% (95% confidence interval [CI], 64%-84%) and 84% (95% CI, 72%-90%), respectively. Interim PET-CT status was not associated with PFS (hazard ratio [HR], 0.9; 95% CI, 0.3-2.7; P =.8) or OS (HR, 0.6; 95% CI, 0.1-2.9; P =.5). Post-treatment PET-CT status was statistically significantly associated with PFS (HR, 5.2; 95% CI, 2.0-13.6; P =.001) and trended toward significant for OS (HR, 2.8; 95% CI, 0.8-9.6; P =.07). CONCLUSIONS: These data do not support the prognostic utility of PET-CT in pretreatment and interim treatment settings. A positive PET-CT after the completion of therapy identifies a patient subset with an inferior PFS and a trend toward inferior OS.

KW - computed tomography

KW - mantle cell lymphoma

KW - non-Hodgkin lymphoma

KW - positron emission tomography

UR - https://www.scopus.com/pages/publications/84863334988

U2 - 10.1002/cncr.26731

DO - 10.1002/cncr.26731

M3 - Article

C2 - 22180256

SN - 0008-543X

VL - 118

SP - 3565

EP - 3570

JO - Cancer

JF - Cancer

IS - 14

ER -