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

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Abstract

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.

Bone Marrow Transplantation (2013) 48, 1212–1217;

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