scholarly journals The impact of pre- and post-transplantation positron emission tomography using 18-fluorodeoxyglucose on poor-prognosis lymphoma patients undergoing autologous stem cell transplantation

Cancer ◽  
2007 ◽  
Vol 110 (6) ◽  
pp. 1361-1369 ◽  
Author(s):  
Jean-Emmanuel Filmont ◽  
Christian Gisselbrecht ◽  
Xavier Cuenca ◽  
Laure Deville ◽  
Marjan Ertault ◽  
...  
Keyword(s):  
Positron Emission Tomography ◽  
Stem Cell ◽  
Stem Cell Transplantation ◽  
Cell Transplantation ◽  
Autologous Stem Cell Transplantation ◽  
Poor Prognosis ◽  
Emission Tomography ◽  
Post Transplantation ◽  
Positron Emission ◽  
The Impact

Impact of Pre-Transplantation and Post-Transplantation Positron Emission Tomography (PET) Using 18-Fluorodeoxyglucose in Lymphoma Patients Treated with Autologous Stem Cell Transplantation.

Blood ◽  
2006 ◽  
Vol 108 (11) ◽  
pp. 3055-3055
Author(s):  
Nicolas Mounier ◽  
Christian Gisselbrecht ◽  
Jean-Emmanuel Filmont ◽  
Xavier Cuenca ◽  
Laure Deville ◽  
...  
Keyword(s):  
Positron Emission Tomography ◽  
Stem Cell ◽  
Relative Risk ◽  
Stem Cell Transplantation ◽  
Cell Transplantation ◽  
Autologous Stem Cell Transplantation ◽  
Emission Tomography ◽  
Front Line ◽  
Positron Emission ◽  
The Impact

Abstract Introduction : Assessment of therapeutic response using 18-Fluoro-deoxy-glucose (FDG) positron emission tomography (PET) is useful to determine prognosis in lymphoma. In poor prognosis lymphoma patients, it may have an important value in the pre-transplant evaluation and help to transplant-decision making. But the impact on patient outcome of post-transplant assessment is unknown. Patients and methods: In our department, between July 2004 and December 2005, 60 consecutive patients (M/F ratio= 37/23) who achieved tumor response and received high-dose chemotherapy plus autologous-stem-cell transplantation (ASCT) were prospectively explored with PET, prior to ASCT (after 3–4 chemotherapy cycles) and 100 days after ASCT. PET images were evaluated without knowledge of conventional imaging and clinical history. Presence (PET positive) or absence (PET negative) of abnormal FDG uptake was related to event-free survival (EFS) and overall survival (OS). Results :50 patients had non-Hodgkin lymphoma (20 diffuse-large-B-cell (DLBCL), 8 mantle-cell, 16 follicular, 4 T-large-cell, 2 Burkitt) and 10 Hodgkin’s lymphoma. Median age was 52 ranging from 19 to 68 years. At diagnosis, 9 patients had 2–4 performance status, 40 elevated LDH, 30 extranodal involvement and 53 staged 3–4. Tumor bulk was above 10 cm in 14 patients. 22 patients received front-line ASCT mainly after ACVBP (n=14) or CHOP. Platinum-based salvage chemotherapy (DHAP, n= 26) was the most frequently used for 27 relapses and 11 refractory diseases. 40 patients received Rituximab with chemotherapy. Prior ASCT, there were 31 complete remission (CR), 23 uncertain CR and 6 partial remission. Conditioning regimen was BEAM in 39 patients; Zevalin BEAM in11, Total Body Irradiation was used in 10. 44 patients (75%) were pre-ASCT-PET negative and 48 (80%) post-ASCT-PET negative. 6 patients (10%) converted from pre-ASCT-PET positive to post-ASCT-PET negative (2 Hodgkin, 1 mantle, 2 follicular, 1 DLBC) and 2 patients (3%) converted from pre-ASCT-PET negative to post-ASCT-PET positive (1 pulmonary infection, 1 early relapse in DLBC). One year after ASCT, 10 patients died (OS 80%) and 17 relapsed (EFS 67%). OS was estimated to 90% in pre-ASCT-PET-negative patients vs. 51 % in PET-positive (p=0.0003), EFS was 75% vs. 43%, respectively (p=0.001). OS was estimated to 87% in post-ASCT-PET-negative patients vs. 48% in PET-positive (p<0.0001), EFS was 77% vs. 25%, respectively (p<0.0001). There was no difference within histological subtypes or front-line vs. relapse/refractory. The only adverse prognostic factors in multivariate analysis was PET positive either pre ASCT (relative risk=4) or post ASCT (relative risk=12). Conclusion: A positive PET after induction chemotherapy indicates a high risk of ASCT failure; in addition, this risk of failure is increased by a positive PET after ASCT. In pre-ASCT-PET-positive patients, more experimental approaches are needed. In pre-ASCT-PET-negative patients, post-ASCT-PET assessment may be omitted.

Positron emission tomography using 18-fluorodeoxyglucose in pre- and post-transplantation in lymphoma patients treated with autologous stem cell transplantation: Impact

2007 ◽  
Vol 25 (18_suppl) ◽  
pp. 8060-8060
Author(s):  
X. Cuenca ◽  
N. Mounier ◽  
G. L. Deville ◽  
P. Brice ◽  
J. Larghero ◽  
...  
Keyword(s):  
Positron Emission Tomography ◽  
Stem Cell ◽  
Stem Cell Transplantation ◽  
Cell Transplantation ◽  
Autologous Stem Cell Transplantation ◽  
Emission Tomography ◽  
Clinical Staging ◽  
High Dose ◽  
Positron Emission ◽  
The Impact

8060 Background: The pre-transplant evaluation of lymphoma with Positron Emission Tomography (PET) scanning using 18- FluoroDeoxyGlucose may ease a decision making. The impact on patient outcome of post-transplant assessment is unknown. Methods: Between July 04 and December 05, patients (pts) who achieved tumor response and received high-dose chemotherapy plus autologous stem cell transplantation (ASCT) were explored with PET, prior and 100 days after ASCT, without knowledge of conventional imaging nor clinical history. PET results (negative or positive) were related to event-free survival (EFS) and overall survival (OS). Results: 60 pts were included. 50 had Non-Hodgkin Lymphoma (26 aggressive) and 10 Hodgkins Lymphoma. Median age was 52 [19-68]. 22 pts received front-line ASCT mainly after ACVBP (n=14) or CHOP. Platinum-based salvage chemotherapy was the most used (n=38), and most of the pts received rituximab (n=40). Prior ASCT,by clinical staging, there were 31 complete remission (CR), 23 uncertain CR and 6 partial remission. Conditioning regimen was BEAM in 39 pts; Zevalin BEAM in 11, Total Body Irradiation in 10. 75% were pre-ASCT-PET negative and 80% post-ASCT-PET negative. 6 pts (10%) converted from pre-ASCT-PET positive to post-ASCT-PET negative and 2 pts from negative to post-ASCT-PET positive. Median follow-up was 1.25 years [0.5–2]. 12 pts died (OS 80%) and 19 relapsed (EFS 68%). OS and EFS was better in pre-ASCT-PET-negative pts than in PET-positive (92% vs 53% (p=0.0009), 77% vs 35%, (p=0.0002) respectively). OS was estimated to 90% in post-ASCT-PET-negative pts vs 50% in PET-positive (p<0.0001), EFS was 79% vs 25%, respectively (p<0.0001). In multivariate analysis,including analysis by histology subtypes, the only adverse prognostic factor was PET positive either pre-ASCT (Relative Risk(RR)=4) or post-ASCT (RR=12). Conclusions: A positive PET after induction chemotherapy indicates a high risk of ASCT failure which is increased by a positive PET after ASCT. In pre-ASCT-PET-positive pts, more experimental approaches are required. In pre-ASCT-PET-negative patients, post-ASCT-PET assessment may be omitted. No significant financial relationships to disclose.

scholarly journals Co-Reactivation of Cytomegalovirus and Epstein-Barr Virus Was Associated With Poor Prognosis After Allogeneic Stem Cell Transplantation

2021 ◽  
Vol 11 ◽  
Author(s):  
Jing-Rui Zhou ◽  
Da-Yu Shi ◽  
Rong Wei ◽  
Yu Wang ◽  
Chen-Hua Yan ◽  
...  
Keyword(s):  
Stem Cell ◽  
T Cell ◽  
Stem Cell Transplantation ◽  
Cell Transplantation ◽  
Poor Prognosis ◽  
Epstein Barr Virus ◽  
Post Transplantation ◽  
Barr Virus ◽  
Epstein Barr ◽  
The Impact

Reactivation of cytomegalovirus (CMV) or Epstein-Barr virus (EBV) is common after hematopoietic stem cell transplantation (HSCT). Previous researches have demonstrated that either CMV or EBV reactivation is associated with poor outcomes of HSCT. However, few studies investigate the impact of CMV and EBV co-reactivation after HSCT. In this study, we described the clinical characteristics of HSCT recipients with CMV and EBV co-reactivation (defined as CMV and EBV viremia occur at the same period of time). We conducted a longitudinal study of 247 patients who underwent HSCT in our center. A total of 24 (9.7%) patients had CMV and EBV co-reactivation. These patients showed higher incidence of viral pneumonitis (P=0.005). Patients with CMV and EBV co-reactivation had significant lower 1-year overall survival (OS) (P=0.004) and lower 1-year leukemia free survival (LFS) (P=0.016). Our further analysis suggested that duration of CMV (P=0.014), EBV (P&lt;0.001), and CD4+CD25+ T cell counts at day 30 post-transplantation (P=0.05) are independent risk factors of virus co-reactivation. In conclusion, patients who developed co-reactivation of CMV and EBV had poor prognosis in terms of lower 1-year OS and LFS, and the CMV and EBV co-reactivation was associated with prolonged CMV or EBV duration and poor CD4+CD25+ T cell reconstitution at day 30 post-transplantation.

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