Focal skeletal FDG uptake indicates poor prognosis in cHL regardless of extent and first-line chemotherapy

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Focal skeletal FDG uptake indicates poor prognosis in cHL regardless of extent and first-line chemotherapy

Pedersen, Mette A. (author): Aarhus Univ Hosp, Dept Nucl Med, Aarhus, Denmark;Aarhus Univ Hosp, PET Ctr, Aarhus, Denmark

Gormsen, Lars C. (author): Aarhus Univ Hosp, Dept Nucl Med, Aarhus, Denmark;Aarhus Univ Hosp, PET Ctr, Aarhus, Denmark

Kamper, Peter (author): Aarhus Univ Hosp, Dept Haematol, Palle Juul Jensens Blvd 99, DK-8200 Aarhus N, Denmark

Wassberg, Cecilia (author): Uppsala universitet,Radiologi

Andersen, Maja D. (author): Aarhus Univ Hosp, Dept Haematol, Palle Juul Jensens Blvd 99, DK-8200 Aarhus N, Denmark

d'Amore, Alexander L. (author): Aarhus Univ Hosp, Dept Haematol, Palle Juul Jensens Blvd 99, DK-8200 Aarhus N, Denmark

Barrington, Sally F. (author): Kings Coll London, London, England;Kings Coll London, Guys & St Thomas PET Ctr, Sch Biomed Engn & Imaging Sci, London, England

Johnson, Peter (author): Univ Southampton, Canc Res UK Ctr, Southampton, Hants, England

Hamilton-Dutoit, Stephen (author): Aarhus Univ Hosp, Dept Pathol, Aarhus N, Denmark

Amini, Rose-Marie (author): Uppsala universitet,Klinisk och experimentell patologi,Rose-Marie Amini

Enblad, Gunilla (author): Uppsala universitet,Experimentell och klinisk onkologi

Molin, Daniel, 1969- (author): Uppsala universitet,Experimentell och klinisk onkologi

d'Amore, Francesco (author): Aarhus Univ Hosp, Dept Haematol, Palle Juul Jensens Blvd 99, DK-8200 Aarhus N, Denmark

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2019-05-22
2019
English.
In: British Journal of Haematology. - : WILEY. - 0007-1048 .- 1365-2141. ; 186:3, s. 431-439

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Journal article (peer-reviewed)

Abstract Subject headings

F-18-fluoro-2-deoxy-D-glucose positron emission tomography/computed tomography (FDG-PET/CT) is used for staging classical Hodgkin lymphoma (cHL) with high sensitivity for skeletal involvement. However, it is unclear whether a single bone lesion carries the same adverse prognosis as multifocal lesions and if this is affected by type of chemotherapy [ABVD (adriamycin, bleomycin, vincristine, dacarbazine) versus BEACOPP (bleomycin, etoposide, adriamycin, cyclophosphamide, vincristine, procarbazine, prednisone)]. We reviewed the clinico-pathological and outcome data from 209 patients with newly diagnosed cHL staged by FDG-PET/CT. Patterns of skeletal/bone marrow uptake (BMU) were divided into 'low' and 'high' diffuse BMU (i.e. without focal lesions), and unifocal or multifocal lesions. Additional separate survival analysis was performed, taking type of chemotherapy into account. Forty patients (19 center dot 2%) had skeletal lesions (20 unifocal, 20 multifocal). The 3-year progression-free-survival (PFS) was 80% for patients with 'low BMU', 87% for 'high BMU', 69% for 'unifocal' and 51% for 'multifocal' lesions; median follow-up was 38 months. The presence of bone lesions, both uni- and multifocal, was associated with significantly inferior PFS (log rank P = 0 center dot 0001), independent of chemotherapy type. Thus, increased diffuse BMU should not be considered as a risk factor in cHL, whereas unifocal or multifocal bone lesions should be regarded as important predictors of adverse outcome, irrespective of the chemotherapy regimen used.

Subject headings

MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Hematologi (hsv//swe)
MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Hematology (hsv//eng)
MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Cancer och onkologi (hsv//swe)
MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Cancer and Oncology (hsv//eng)
MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Klinisk laboratoriemedicin (hsv//swe)
MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Clinical Laboratory Medicine (hsv//eng)

Keyword

F-18-FDG PET
CT
classical Hodgkin lymphoma
bone marrow uptake
focal bone lesions
chemotherapy
Patologi
Pathology

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ref (subject category)
art (subject category)

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MEDICAL AND HEALTH SCIENCES: MEDICAL AND HEAL ...; and Clinical Medicin ...; and Hematology

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