Faculty Collaboration Database

Impact of Routine Surveillance Imaging on Outcomes of Patients With Diffuse Large B-Cell Lymphoma After Autologous Hematopoietic Cell Transplantation. Clin Lymphoma Myeloma Leuk 2016 Dec;16(12):672-678

Date

09/24/2016

Pubmed ID

27660080

DOI

10.1016/j.clml.2016.08.018

Scopus ID

2-s2.0-84997605125 (requires institutional sign-in at Scopus site)   7 Citations

Abstract

BACKGROUND: For patients with relapsed or refractory diffuse large B-cell lymphoma (DLBCL), autologous hematopoietic cell transplantation (auto-HCT) is commonly used. After auto-HCT, DLBCL patients are often monitored with surveillance imaging. However, there is little evidence to support this practice.

PATIENTS AND METHODS: We performed a multicenter retrospective study of DLBCL patients who underwent auto-HCT (n = 160), who experienced complete remission after transplantation, and who then underwent surveillance imaging. Of these, only 45 patients experienced relapse after day +100 after auto-HCT, with relapse detected by routine imaging in 32 (71%) and relapse detected clinically in 13 (29%).

RESULTS: Baseline patient characteristics were similar between the 2 groups. Comparing the radiographic and clinically detected relapse groups, the median time from diagnosis to auto-HCT (389 days vs. 621 days, P = .06) and the median follow-up after auto-HCT (2464 days vs. 1593 days P = .60) were similar. The median time to relapse after auto-HCT was 191 days in radiographically detected relapses compared to 492 days in clinically detected relapses (P = .35), and median postrelapse survival was 359 days in such patients compared to 123 days in patients with clinically detected relapse (P = .36). However, the median posttransplantation overall survival was not significantly different for patients with relapse detected by routine imaging versus relapse detected clinically (643 vs. 586 days, P = .68).

CONCLUSION: A majority (71%) of DLBCL relapses after auto-HCT are detected by routine surveillance imaging. Overall, there appears to be limited utility for routine imaging after auto-HCT except in select cases where earlier detection and salvage therapy with allogeneic HCT is a potential option.

Author List

Epperla N, Shah N, Hamadani M, Richardson K, Kapke JT, Patel A, Teegavarapu SP, Carrum G, Hari PN, Pingali SR, Karmali R, Fenske TS

Authors

Timothy Fenske MD Professor in the Medicine department at Medical College of Wisconsin
Mehdi H. Hamadani MD Professor in the Medicine department at Medical College of Wisconsin
Parameswaran Hari MD Adjunct Professor in the Medicine department at Medical College of Wisconsin

MESH terms used to index this publication - Major topics in bold

Combined Modality Therapy
Diagnostic Imaging
Female
Hematopoietic Stem Cell Transplantation
Humans
Lymphoma, Large B-Cell, Diffuse
Male
Monitoring, Physiologic
Neoplasm Staging
Positron Emission Tomography Computed Tomography
Positron-Emission Tomography
Postoperative Care
Recurrence
Retrospective Studies
Survival Analysis
Time Factors
Tomography, X-Ray Computed
Transplantation, Autologous
Treatment Outcome
Workflow