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Prognostic value of pre-transplantation total metabolic tumor volume on 18fluoro-2-deoxy-d-glucose positron emission tomography–computed tomography in relapsed and refractory aggressive lymphoma

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Abstract

Relapsed and refractory aggressive lymphoma have a poor prognosis. High-dose chemotherapy followed by autologous hematopoietic stem cell transplantation (auto-HSCT) is effective in chemosensitive patients. Allogeneic hematopoietic stem cell transplantation (allo-HSCT) is among the few options for non-chemosensitive patients. 18Fluoro-2-deoxy-d-glucose positron emission tomography–computed tomography (18FDG-PET/CT) is the standard tool for evaluating response to chemotherapy and residual tumor volume. However, accurate assessment of residual tumor volume is not currently being achieved in clinical practice, and its value in prognostic and therapeutic stratification remains unclear. To answer this question, we investigated the efficacy of quantitative indicators, including total metabolic tumor volume (TMTV), in predicting prognosis after auto-HSCT and allo-HSCT. We retrospectively analyzed 39 patients who received auto-HSCT and 28 who received allo-HSCT. In the auto-HSCT group, patients with a higher TMTV had a poor prognosis due to greater risk of relapse. In the allo-HSCT group, patients with a higher TMTV had a lower progression-free survival rate and a significantly higher relapse rate. Neither Deauville score nor other clinical parameters were associated with prognosis in either group. Therefore, pre-transplant TMTV on PET is effective for prognostic prediction and therapeutic decision-making for relapsed or refractory aggressive lymphoma.

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Acknowledgements

We thank all the medical and nursing staff working in the Kyushu University Hospital for providing dedicated medical care.

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Authors and Affiliations

  1. Department of Medicine and Biosystemic Science, Kyushu University Graduate School of Medical Sciences, 3-1-1 Maidashi, Higashi-ku, Fukuoka, 812-8582, Japan

    Takeshi Sugio, Yasuo Mori, Goichi Yoshimoto, Kenjiro Kamesaki, Shuichiro Takashima, Shingo Urata, Takahiro Shima, Kohta Miyawaki, Yoshikane Kikushige, Yuya Kunisaki, Akihiko Numata, Katsuto Takenaka, Hiromi Iawasaki, Toshihiro Miyamoto & Koji Kato

  2. Department of Clinical Radiology, Kyushu University Graduate School of Medical Sciences, Fukuoka, Japan

    Shingo Baba & Kousei Ishigami

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Koji Kato–Consulting fees: AbbVie, AstraZeneca, Celgene, Chugai, Eisai, Janssen, Novartis, Daiichi Sankyo; Honoraria (e.g., lecture fees): Takeda, MSD, Kyowa-Kirin, Janssen, Celgene, Ono, Mundi, Dainippon-Sumitomo, Bristol-Myers Squibb; Research funding: Chugai, Takeda, Kyowa-Kirin, AbbVie, Novartis, Eisai, Janssen, Celgene, Ono, Novartis, Daiichi Sankyo.

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Sugio, T., Baba, S., Mori, Y. et al. Prognostic value of pre-transplantation total metabolic tumor volume on 18fluoro-2-deoxy-d-glucose positron emission tomography–computed tomography in relapsed and refractory aggressive lymphoma. Int J Hematol 116, 603–611 (2022). https://doi.org/10.1007/s12185-022-03394-w

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