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Non-Hodgkin's Lymphoma

Pre-transplant positron emission tomography (PET) using fluorine-18-fluoro-deoxyglucose (FDG) predicts outcome in patients treated with high-dose chemotherapy and autologous stem cell transplantation for non-Hodgkin's lymphoma

Bone Marrow Transplantation volume 30, pages 103–111 (2002)Cite this article

An Erratum to this article was published on 06 November 2002

Abstract

We investigated the predictive value of sequential FDG PET before and after high-dose chemotherapy (HDT) and autologous stem cell transplantation (ASCT) in 24 patients suffering from non-Hodgkin's lymphoma (NHL). FDG PET was performed at baseline, after three cycles of induction therapy, before and after HDT with ASCT. Response assessment from sequential PET scans using standardized uptake values (SUV) was available in 22 patients at the time of transplantation. Partial metabolic response (PMR) was defined as a <25% decrease of SUV between successive PET scans. Six of seven patients who did not achieve a PMR after complete induction therapy developed lymphoma progression, while 10 of 15 patients with complete metabolic response (CMR) or PMR remained in continuous remission. Four of seven patients with less than PMR after induction therapy died vstwo of 15 patients with CMR/PMR. Median progression-free and overall survival of patients with less than PMR after HDT and ASCT was 9 and 29 months, respectively. In contrast, neither conventional re-staging nor the International Prognostic Index were predictive. These data suggest that sequential quantitative PET imaging does enlarge the concept of chemosensitivity used to select patients with high-risk NHL for HDT and ASCT or to route them to alternative treatments.

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Acknowledgements

The authors thank the staff of the Nuclear Medicine Department for assistance in PET acquisition and image documentation and interpretation and Peter Glatte and Stefan Reismann for collecting and handling the clinical and PET data. Moreover we thank Prof Johann Lorenzen for a thorough review of the histopathological lymphoma classification and Prof Ralf-Dieter Hilgers for his valuable advice concerning the statistics. The study has been supported by a grant from the Medical Faculty of the Aachen University of Technology.

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Authors and Affiliations

  1. Department of Nuclear Medicine, Aachen University of Technology, Aachen, Germany

    U Cremerius, M Zimny, P Reinartz, B Nowak, W Schaefer & U Buell

  2. Department of Internal Medicine IV, Aachen University of Technology, Aachen, Germany

    U Fabry & R Osieka

  3. Department of Diagnostic Radiology, Aachen University of Technology, Aachen, Germany

    JE Wildberger

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  1. U Cremerius
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Cremerius, U., Fabry, U., Wildberger, J. et al. Pre-transplant positron emission tomography (PET) using fluorine-18-fluoro-deoxyglucose (FDG) predicts outcome in patients treated with high-dose chemotherapy and autologous stem cell transplantation for non-Hodgkin's lymphoma. Bone Marrow Transplant 30, 103–111 (2002). https://doi.org/10.1038/sj.bmt.1703607

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