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18F-Fluorodeoxyglucose positron emission tomography/ computed tomography (PET/CT) is a highly accurate staging method in classical Hodgkin lymphoma (cHL). We retrospectively compared the staging results obtained in two large cohorts of patients with cHL diagnosed before ( n = 324) and after ( n = 406) the introduction of PET/CT staging in a retrospective study. In PET/CT staged patients, stage I disease was less frequent (16% vs. 27%, p < 0.001) while stage IV disease was more frequent (17% vs. 10%, p = 0.02). Imaging-detected skeletal involvement was recognized more often in PET/CT staged patients (17% vs. 2%, p < 0.001), and the presence of focal skeletal PET/CT lesions was associated with higher risk of progression (hazard ratio [HR] 1.96, 95% confidence interval [CI]: 1.14-3.36). The German Hodgkin Study Group (GHSG) risk classification (early, intermediate, advanced disease) predicted outcome in PET/CT staged patients. In conclusion, PET/CT led to higher disease stages, and the more frequently diagnosed skeletal lesions may be an adverse prognostic factor. [ABSTRACT FROM AUTHOR]

Positron emission tomography using [18F]-fluoro-2-deoxy-d-glucose (FDG-PET) is an important tool for staging and treatment response assessment in malignant lymphomas. In Hodgkin lymphoma (HL), FDG-PET precisely predicts the therapy response when performed very early during standard ABVD chemotherapy. However, it is unclear whether FDG-PET retains this role if therapy is changed as a consequence of the scan, or if performed during a more intensive chemotherapy regimen such as BEACOPPesc, which is used for HL. This brief review presents the up-to-date evidence for the use and interpretation of early interim FDG-PET in HL, including recent preliminary results on early interim FDG-PET during BEACOPPesc therapy. [ABSTRACT FROM AUTHOR]

The article notes the high incidence of treatment-related late morbidity and mortality among patients treated for Hodgkin lymphoma, and discusses efforts to identify patients in which treatment-related toxicity could be reduced by means of lower treatment intensity. Particular attention is given to a study that found a potential link between the intensity of the PET (positron emission tomography) in Hodgkin lymphoma and the expression of glucose transporters.

The author discusses the study of G. A. Abel and colleagues which examines the significance and patterns of surveillance imaging in patients with diffuse large B-cell lymphoma (DLBCL) in remission. They mention that the multi-institutional survey has focused on first two years of post-treatment via surveillance imaging. They say that those patients who were randomised to low-intensity surveillance imaging have a risk relapse compared to those who have DLBCL in remission following chemotherapy.

The article comments on a study on routine bone marrow biopsy for Hodgkin lymphoma (HL) by S. Richardson and colleagues published in this journal. The study included 392 patients with HL, including 190 patients with advanced stage disease and 202 patients with early stage disease. The author observes that the result revealed that BMB should not be performed routinely in HL patients undergoing positron emission tomography staging.

In this article the author discusses the retrospective Czech experience of Dr. Mocikova and colleagues in the application of pre-transplant positron emission tomography (PET) and computed tomography (CT) on patients with relapsed Hodgkin lymphoma (HL). It notes the higher 2-year progression-free survival (PFS) in PET-negative patients than PET-positive patients. It also highlights the use of histone deacetylase (HDAC) inhibitors and brentuximab vedotin (SG-35) on pretreated HL patients.

In this article the author discusses the study of T. El-Galaly and colleagues which presents the efficacy of routine post-treatment surveillance with positron emission tomography/computed tomography (PET/CT) to aggressive non-Hodgkin lymphoma (NHL) patients. He states that the addition of PET/CT to routine surveillance showed an early detection of one single relapse. He also explores two studies which use chest X-ray and CT scans and both confirmed that most of the relapses were symptomatic.

We evaluated the predictive value of interim positon emission tomography (I-PET) after one course of chemoimmunotherapy in patients with newly diagnosed diffuse large B-cell lymphoma (DLBCL). One hundred and twelve patients with DLBCL were enrolled. All patients had PET/computed tomography (CT) scans performed after one course of chemotherapy (PET-1). I-PET scans were categorized according to International Harmonization Project criteria (IHP), Deauville 5-point scale (D 5PS) with scores 1-3 considered negative (D 5PS > 3) and D 5PS with scores 1-4 considered negative (D 5PS = 5). Ratios of tumor maximum standardized uptake value (SUVmax) to liver SUVmax were also analyzed. We found no difference in progression-free survival (PFS) between PET-negative and PET-positive patients according to IHP and D 5PS > 3. The 2-year PFS using D 5PS = 5 was 50.9% in the PET-positive group and 84.8% in the PET-negative group ( p = 0.002). A tumor/liver SUVmax cut-off of 3.1 to distinguish D 5PS scores of 4 and 5 provided the best prognostic value. PET after one course of chemotherapy was not able to safely discriminate PET-positive and PET-negative patients in different prognostic groups. [ABSTRACT FROM AUTHOR]

The aim of this study was to evaluate the prognostic value of clinician interpretation of positron emission tomography/computed tomography (PET/CT) reports at mid-therapy, interim PET (I-PET) and after the end of first-line therapy (E-PET) in patients with diffuse large B-cell lymphoma (DLBCL). Four hundred and thirty patients were enrolled in this study comprising a total of 617 PET reports. Each report was evaluated by three expert hematologists randomly selected from a panel of nine. Reports were labeled positive or negative if all three interpreters agreed. All others were considered indeterminate. Indeterminate reports accounted for 59% of I-PET and 49% of E-PET reports. Two-year overall survival (OS) for patients with a positive, indeterminate and negative I-PET was 58%, 87% and 89% ( p < 0.001), respectively. Two-year OS for patients with E-PET was 41%, 89% and 97% ( p < 0.001) for positive, indeterminate and negative interpretation of PET/CT reports. Progression-free survival and OS did not differ significantly in patients with a negative and an indeterminate I-PET report. The use of well-defined reporting criteria, e.g. the Deauville five-point scale, is likely to reduce the number of scans perceived as indeterminate. [ABSTRACT FROM AUTHOR]

A review of the article "2-[18F]fluoro-2-deoxyd-glucose positron emission tomography/computed tomography examination in patients with chronic lymphocytic leukemia may reveal Richter transformation," by T. Papajík, M. Mysliveček, R. Urbanová and others is presented.

The article presents abstracts on medical topics including the involvement of bone marrow in Hodgkin lymphoma, the metabolic response in interim positron emission tomography (PET) during Hodgkin lymphoma treatment, and the outcome of aggressive non-Hodgkin lymphoma patients with negative pretreatment PET scan.