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- Title
Prognostic value of pretransplant FDG-PET in refractory/relapsed Hodgkin lymphoma treated with autologous stem cell transplantation: systematic review and meta-analysis.
- Authors
Adams, Hugo; Kwee, Thomas; Adams, Hugo J A; Kwee, Thomas C
- Abstract
This study aimed to systematically review the prognostic value of pretransplant (18)F-fluoro-2-deoxy-D-glucose positron emission tomography (FDG-PET) in refractory/relapsed Hodgkin lymphoma treated with autologous stem cell transplantation (SCT). MEDLINE was systematically searched for appropriate studies. Included studies were methodologically appraised. Results of individual studies were meta-analyzed, if possible. Eleven studies, comprising a total of 745 refractory/relapsed Hodgkin lymphoma patients who underwent FDG-PET before autologous SCT, were included. The overall methodological quality of these studies was moderate. The proportion of pretransplant FDG-PET positive patients ranged between 25 and 65.2 %. Progression-free survival ranged between 0 and 52 % in pretransplant FDG-PET positive patients, and between 55 and 85 % in pretransplant FDG-PET negative patients. Overall survival ranged between 17 and 77 % in pretransplant FDG-PET positive patients, and between 78 and 100 % in FDG-PET negative patients. Based on five studies that provided sufficient data for meta-analysis, pooled sensitivity and specificity of pretransplant FDG-PET in predicting treatment failure (i.e., either progressive, residual, or relapsed disease) were 67.2 % (95 % confidence interval [CI] 58.2-75.3 %) and 70.7 % (95 % CI 64.2-76.5 %), respectively. Based on two studies that provided sufficient data for meta-analysis, pooled sensitivity and specificity of pretransplant FDG-PET in predicting death during follow-up were 74.4 % (95 % CI 58.8-86.5 %) and 58.0 % (95 % CI 49.3-66.3 %), respectively. In conclusion, the moderate quality evidence suggests pretransplant FDG-PET to have value in predicting outcome in refractory/relapsed Hodgkin lymphoma patients treated with autologous SCT. Nevertheless, a considerable proportion of pretransplant FDG-PET positive patients remains disease free and a considerable proportion of pretransplant FDG-PET negative patients develops disease relapse after autologous SCT.
- Subjects
PROGNOSIS; HODGKIN'S disease treatment; STEM cell transplantation research; POSITRON emission tomography; CANCER relapse; ANTINEOPLASTIC agents; CARCINOGENESIS; AUTOGRAFTS; BONE marrow transplantation; CLINICAL trials; COMBINED modality therapy; DEOXY sugars; DRUG resistance in cancer cells; FLUORINE isotopes; HEMATOPOIETIC stem cell transplantation; HODGKIN'S disease; LONGITUDINAL method; META-analysis; RADIOISOTOPES; RADIOPHARMACEUTICALS; SURVIVAL analysis (Biometry); SYSTEMATIC reviews; DISEASE relapse; TREATMENT effectiveness; DISEASE progression; SALVAGE therapy
- Publication
Annals of Hematology, 2016, Vol 95, Issue 5, p695
- ISSN
0939-5555
- Publication type
journal article
- DOI
10.1007/s00277-016-2619-9