Ability of final PET/CT to predict response to first-line treatment in real patients with classical Hodgkin lymphoma

Int J Hematol. 2022 Jan;115(1):54-60. doi: 10.1007/s12185-021-03223-6. Epub 2021 Sep 21.

Abstract

Up to 25% of patients with classical Hodgkin lymphoma (cHL) and a negative interim PET/CT will progress. Unfortunately, there are few published studies on the predictive value of PET/CT performed after finishing treatment. The objective of our study was to assess the role of the final PET/CT (fPET/CT) in predicting progression in a retrospective series of patients treated in the last 10 years with a homogeneous protocol (ABVD + / - radiotherapy). We reviewed a cohort of 227 patients with newly diagnosed cHL. fPET/CT was performed on 212 patients (93%). In patients with a positive fPET, progression-free survival at 60 months was 17% (94% if fPET was negative, p = 0.000). The positive and negative predictive values for the fPET were 76% and 94%, respectively (Fisher's exact test, p = 0.000). In the subgroup of patients with advanced-stage cHL, progression-free survival at 60 months was 91% with negative fPET and 0% with positive fPET (p = 0.000). However, fPET was negative in 19 of the 29 patients with a positive interim PET/CT (only 2 showed progression). In conclusion, fPET is a useful tool to predict treatment failure in patients with newly diagnosed cHL, especially advanced-stage disease.

Keywords: Hodgkin lymphoma; PET; Predictive value.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Antineoplastic Combined Chemotherapy Protocols / administration & dosage*
  • Bleomycin / administration & dosage
  • Dacarbazine / administration & dosage
  • Disease-Free Survival
  • Doxorubicin / administration & dosage
  • Female
  • Hodgkin Disease / diagnostic imaging*
  • Hodgkin Disease / mortality
  • Hodgkin Disease / therapy*
  • Humans
  • Male
  • Middle Aged
  • Neoplasm Staging
  • Positron Emission Tomography Computed Tomography / methods*
  • Predictive Value of Tests
  • Radiotherapy*
  • Retrospective Studies
  • Survival Rate
  • Treatment Failure
  • Vinblastine / administration & dosage
  • Young Adult

Substances

  • Bleomycin
  • Vinblastine
  • Dacarbazine
  • Doxorubicin

Supplementary concepts

  • ABVD protocol