Journal article
Outcomes Among Classical Hodgkin Lymphoma Patients After an Interim PET Scan: A Real-World Experience
Clinical lymphoma, myeloma and leukemia, Vol.22(7), pp.e435-e442
07/2022
DOI: 10.1016/j.clml.2021.12.012
PMID: 35093285
Abstract
The utility of dose escalation after positive positron emission tomography following 2 cycles of ABVD (PET2) for Hodgkin Lymphoma (HL) remains controversial. We describe the United States real-world practice patterns for PET2 positive patients.
Data was collected from 15 sites on PET2 positive HL patients after receiving frontline treatment between January, 2015 and June, 2019. Descriptive analyses between those with therapy change and those continuing initial therapy were assessed.
A total of 129 patients were identified; 111 (86%) were treated with ABVD therapy and 18 (14%) with an alternate regimen. At PET2 assessment, 74.4% (96/129) had Deauville score (DS) 4 and 25.6% (33/129) had DS 5. Of the 66 limited stage (LS) patients with PET2 DS score of 4/5, 77.3% (51/66) continued initial therapy and 22.7% (15/66) changed to escalated therapy. The 12-month progression-free survival (PFS) for DS 4/5 LS patients was 67.0% (95% CI; 54.9-81.7) for patients without escalation compared with 51.4% (95% CI; 30.8-85.8) for those who escalated. Of the 63 DS 4/5 patients with advanced stage (AS) disease, 76.2% (48/63) continued initial therapy and 23.8% (15/63) changed to escalated therapy. The 12-month PFS for DS 4/5 AS patients was 38.3% (95% CI: 26.3%-55.7%) for patients without escalation compared with 57.1% (95% CI: 36.3-89.9) for those with escalation.
A minority of PET2 positive HL patients undergo therapy escalation and outcomes remain overall suboptimal. Improved prognostics markers and better therapeutics are required to improve outcomes for high-risk PET2 positive HL patients.
Due to lack of prospective studies, we had conducted a retrospective study of 15 centers evaluating the outcomes comparing therapy escalation with continuation of therapy, after a positive PET2 in Hodgkin Lymphoma. The results demonstrated the heterogeneity of approaches, with less than 25% undergoing therapy escalation with survival benefit. Novel solutions should be explored to further improve outcomes.
Details
- Title: Subtitle
- Outcomes Among Classical Hodgkin Lymphoma Patients After an Interim PET Scan: A Real-World Experience
- Creators
- Muhammad Saad Hamid - University of Tennessee Health Science CenterSarah C. Rutherford - Cornell UniversityHyejeong Jang - The Barbara Ann Karmanos Cancer InstituteSeongho Kim - The Barbara Ann Karmanos Cancer InstituteKrish Patel - Swedish Cancer InstituteNancy L. Bartlett - Washington University Medical University at St. Louis, St. Louis, MO, USAMary-Kate Malecek - Washington University Medical University at St. Louis, St. Louis, MO, USAMarcus P. Watkins - Washington University Medical University at St. Louis, St. Louis, MO, USAKami J. Maddocks - The Ohio State UniversityDavid A. Bond - The Ohio State UniversityTatyana A. Feldman - Hackensack Meridian HealthGabriela Magarelli - Hackensack Meridian HealthRanjana H Advani - Stanford UniversityMichael A Spinner - Stanford UniversityAndrew M. Evens - Rutgers, The State University of New JerseyMansi Shah - Rutgers Cancer Institute of New Jersey, New Brunswick, NJ, USASairah Ahmed - MD Anderson Cancer Center, Houston, TXDeborah M. Stephens - Huntsman Cancer InstitutePamela Allen - Emory UniversityMichael T. Tees - Colorado Blood Cancer InstituteReem Karmali - Northwestern UniversityBruce D. Cheson - Lombardi Comprehensive Cancer Center, Washington D.C., USAChristopher Strouse - University of IowaNeil A. Bailey - Swedish Cancer InstituteJohn M. Pagel - Swedish Cancer InstituteRadhakrishnan Ramchandren - University of Tennessee Medical Center
- Resource Type
- Journal article
- Publication Details
- Clinical lymphoma, myeloma and leukemia, Vol.22(7), pp.e435-e442
- Publisher
- Elsevier Inc
- DOI
- 10.1016/j.clml.2021.12.012
- PMID
- 35093285
- ISSN
- 2152-2650
- eISSN
- 2152-2669
- Language
- English
- Date published
- 07/2022
- Academic Unit
- Hematology, Oncology, and Blood & Marrow Transplantation; Internal Medicine
- Record Identifier
- 9984359924602771
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