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

Bone Marrow Transplant. 2013 Sep;48(9):1212-7. doi: 10.1038/bmt.2013.46. Epub 2013 Apr 15.

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.

MeSH terms

  • Adult
  • Aged
  • Disease-Free Survival
  • Female
  • Hematopoietic Stem Cell Transplantation / methods*
  • Humans
  • Lymphoma, Mantle-Cell / diagnosis*
  • Lymphoma, Mantle-Cell / diagnostic imaging
  • Lymphoma, Mantle-Cell / surgery*
  • Male
  • Middle Aged
  • Multimodal Imaging / methods*
  • Positron-Emission Tomography / methods*
  • Prognosis
  • Retrospective Studies
  • Tomography, X-Ray Computed / methods*
  • Transplantation Conditioning / methods
  • Transplantation, Homologous
  • Treatment Outcome