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Pre-autologous transplantation PET/CT using Deauville criteria is an independent predictor of progression in relapsed refractory classical Hodgkin lymphoma

Bone Marrow Transplantation volume 52, pages 1342–1344 (2017)Cite this article

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High-dose salvage chemotherapy followed by haematopoietic stem cell transplantation (HCT) is the standard of care in transplant eligible relapsed/refractory (R/R) classical Hodgkin lymphoma (cHL).1 Approximately, half of patients receiving HCT will achieve long-term remissions, but relapse remains the most common cause of treatment failure. A number of prior studies investigated the value of pre-HCT positron emission tomography (PET) scan as a predictor of outcome. Considerable heterogeneity is noted within these studies due to methodology of PET interpretation, timeline of the scan prior to HCT and whether further clinical decisions were based on the scan results.2, 3, 4, 5 In light of the above, we examined the impact of pre-HCT PET/CT graded on the five-point scale Deauville criteria on the post-HCT outcome.

After due institutional review board (IRB) approval to conduct this retrospective review, patients ⩾14 years of age with R/R cHL who underwent HCT at our institution between 2010 and 2016 were identified. Patients were eligible if they had histologically proven evidence of relapsed disease and had achieved a partial response (PR) or better to salvage therapy at the time of HCT defined as per the International Harmonization Project response criteria.6 All patients underwent PET/CT staging pre-HCT, and standardized uptake value of the liver and mediastinum was noted and was classified per Deauville criteria as ⩽liver uptake or ⩽mediastinal blood pool.7 Patients with uptake ⩽liver (that is, Deauville 3) were deemed to have complete metabolic remission (CMR) and those with uptake >liver (that is, Deauville ⩾4) were deemed to have partial metabolic response (PMR). Patients obtaining less than complete response (CR) within 3 months from the end of first-line therapy were deemed refractory. All patients had pre-HCT staging by computed tomography (CT) of the neck, chest, abdomen and pelvis in conjunction with dual modality PET/CT scan. Patients who met PR per CT criteria proceeded to transplant. Results of the PET/CT did not influence the decision to administer further salvage therapy.

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Acknowledgements

Ethical standards statement: IRB approved the conduct of the study and waived the requirement for informed consent due to retrospective non-interventional study design. All procedures followed were in accordance with the ethical standards of the responsible committee on human experimentation (institutional and national) and with the Helsinki Declaration of 1975, as revised in 2008.

Author contributions

Designed the study: MD. Collected data: MD and SG. Provided patients: all authors. Wrote and reviewed the manuscript: all authors.

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Authors and Affiliations

  1. Department of Oncology, Division of Hematology and HCT, King Abdulaziz Medical City, Riyadh, Saudi Arabia

    M Damlaj, S Ghazi, T Pasha, G Gmati, H Salama, O Ali, K A Abuelgasim, M Al-Zahrani, A Hejazi & A Al Askar

  2. Department of Medical Imaging, King Abdulaziz Medical City, Riyadh, Saudi Arabia

    G Syed

  3. King Abdullah International Medical Research Center, Riyadh, Saudi Arabia

    A Al Askar

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  1. M Damlaj
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  2. S Ghazi
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Correspondence to M Damlaj.

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Damlaj, M., Ghazi, S., Syed, G. et al. Pre-autologous transplantation PET/CT using Deauville criteria is an independent predictor of progression in relapsed refractory classical Hodgkin lymphoma. Bone Marrow Transplant 52, 1342–1344 (2017). https://doi.org/10.1038/bmt.2017.143

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