TY - JOUR
T1 - Effect of Routine Surveillance Imaging on the Outcomes of Patients With Classical Hodgkin Lymphoma After Autologous Hematopoietic Cell Transplantation
AU - Kapke, Jonathan T.
AU - Epperla, Narendranath
AU - Shah, Namrata
AU - Richardson, Kristin
AU - Carrum, George
AU - Hari, Parameswaran N.
AU - Pingali, Sai R.
AU - Hamadani, Mehdi
AU - Karmali, Reem
AU - Fenske, Timothy S.
N1 - Publisher Copyright:
© 2017 Elsevier Inc.
Copyright:
Copyright 2018 Elsevier B.V., All rights reserved.
PY - 2017/7
Y1 - 2017/7
N2 - Surveillance imaging is often used following autologous hematopoietic cell transplantation (auto-HCT) to assess for relapse. We evaluated classical Hodgkin lymphoma (cHL) patients who received auto-HCT, achieved complete remission, and underwent surveillance imaging. Relapse was detected clinically or by surveillance imaging. Outcomes were similar between the two groups. There appears to be limited utility for surveillance imaging in cHL after auto-HCT. Background Patients with relapsed and refractory classical Hodgkin lymphoma (cHL) are often treated with autologous hematopoietic cell transplantation (auto-HCT). After auto-HCT, most transplant centers implement routine surveillance imaging to monitor for disease relapse; however, there is limited evidence to support this practice. Patients and Methods In this multicenter, retrospective study, we identified cHL patients (n = 128) who received auto-HCT, achieved complete remission (CR) after transplantation, and then were followed with routine surveillance imaging. Of these, 29 (23%) relapsed after day 100 after auto-HCT. Relapse was detected clinically in 14 patients and with routine surveillance imaging in 15 patients. Results When clinically detected relapse was compared with to radiographically detected relapse respectively, the median overall survival (2084 days [range, 225-4161] vs. 2737 days [range, 172-2750]; P = .51), the median time to relapse (247 days [range, 141-3974] vs. 814 days [range, 96-1682]; P = .30) and the median postrelapse survival (674 days [range, 13-1883] vs. 1146 days [range, 4-2548]; P = .52) were not statistically different. In patients who never relapsed after auto-HCT, a median of 4 (range, 1-25) surveillance imaging studies were performed over a median follow-up period of 3.5 years. Conclusion A minority of patients with cHL who achieve CR after auto-HCT will ultimately relapse. Surveillance imaging detected approximately half of relapses; however, outcomes were similar for those whose relapse was detected using routine surveillance imaging versus detected clinically in between surveillance imaging studies. There appears to be limited utility for routine surveillance imaging in cHL patients who achieve CR after auto-HCT.
AB - Surveillance imaging is often used following autologous hematopoietic cell transplantation (auto-HCT) to assess for relapse. We evaluated classical Hodgkin lymphoma (cHL) patients who received auto-HCT, achieved complete remission, and underwent surveillance imaging. Relapse was detected clinically or by surveillance imaging. Outcomes were similar between the two groups. There appears to be limited utility for surveillance imaging in cHL after auto-HCT. Background Patients with relapsed and refractory classical Hodgkin lymphoma (cHL) are often treated with autologous hematopoietic cell transplantation (auto-HCT). After auto-HCT, most transplant centers implement routine surveillance imaging to monitor for disease relapse; however, there is limited evidence to support this practice. Patients and Methods In this multicenter, retrospective study, we identified cHL patients (n = 128) who received auto-HCT, achieved complete remission (CR) after transplantation, and then were followed with routine surveillance imaging. Of these, 29 (23%) relapsed after day 100 after auto-HCT. Relapse was detected clinically in 14 patients and with routine surveillance imaging in 15 patients. Results When clinically detected relapse was compared with to radiographically detected relapse respectively, the median overall survival (2084 days [range, 225-4161] vs. 2737 days [range, 172-2750]; P = .51), the median time to relapse (247 days [range, 141-3974] vs. 814 days [range, 96-1682]; P = .30) and the median postrelapse survival (674 days [range, 13-1883] vs. 1146 days [range, 4-2548]; P = .52) were not statistically different. In patients who never relapsed after auto-HCT, a median of 4 (range, 1-25) surveillance imaging studies were performed over a median follow-up period of 3.5 years. Conclusion A minority of patients with cHL who achieve CR after auto-HCT will ultimately relapse. Surveillance imaging detected approximately half of relapses; however, outcomes were similar for those whose relapse was detected using routine surveillance imaging versus detected clinically in between surveillance imaging studies. There appears to be limited utility for routine surveillance imaging in cHL patients who achieve CR after auto-HCT.
KW - Auto-HCT
KW - Classical Hodgkin lymphoma
KW - Lymphoma
KW - Relapse
KW - Surveillance imaging
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U2 - 10.1016/j.clml.2017.05.005
DO - 10.1016/j.clml.2017.05.005
M3 - Article
C2 - 28756899
AN - SCOPUS:85026407137
SN - 2152-2650
VL - 17
SP - 408
EP - 414
JO - Clinical Lymphoma, Myeloma and Leukemia
JF - Clinical Lymphoma, Myeloma and Leukemia
IS - 7
ER -