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Baseline metabolic tumour burden improves risk stratification in Hodgkin lymphoma: A Children's Oncology Group study.
- Source :
-
British journal of haematology [Br J Haematol] 2023 Jun; Vol. 201 (6), pp. 1192-1199. Date of Electronic Publication: 2023 Mar 15. - Publication Year :
- 2023
-
Abstract
- The Children's Oncology Group AHOD0831 study used a positron emission tomography (PET) response-adapted approach in high-risk Hodgkin lymphoma, whereby slow early responders (SERs) received more intensive therapy than rapid early responders (RERs). We explored if baseline PET-based characteristics would improve risk stratification. Of 166 patients enrolled in the COG AHOD0831 study, 94 (57%) had baseline PET scans evaluable for quantitative analysis. For these patients, total body metabolic tumour volume (MTV), total lesion glycolysis (TLG), maximum standardized uptake value (SUV <subscript>max</subscript> ) and peak SUV (SUV <subscript>peak</subscript> ) were obtained. MTV/TLG thresholds were an SUV of 2.5 (MTV <subscript>2.5</subscript> /TLG <subscript>2.5</subscript> ) and 40% of the tumour SUV <subscript>max</subscript> (MTV <subscript>40%</subscript> /TLG <subscript>40%</subscript> ). TLG <subscript>2.5</subscript> was associated with event-free survival (EFS) in the complete cohort (p = 0.04) and in RERs (p = 0.01), but not in SERs (p = 0.8). The Youden index cut-off for TLG <subscript>2.5</subscript> was 1841. Four-year EFS was 92% for RER/TLG <subscript>2.5</subscript>  up to 1841, 60% for RER/TLG <subscript>2.5</subscript>  greater than 1841, 74% for SER/TLG <subscript>2.5</subscript>  up to 1841 and 79% for SER/TLG <subscript>2.5</subscript>  greater than 1841. Second EFS for RER/TLG <subscript>2.5</subscript>  up to 1841 was 100%. Thus, RERs with a low baseline TLG <subscript>2.5</subscript> experienced excellent EFS with less intensive therapy, whereas RERs with a high baseline TLG <subscript>2.5</subscript> experienced poor EFS. These findings suggest that patients with a high upfront tumour burden may benefit from intensified therapy, even if they achieve a RER.<br /> (© 2023 British Society for Haematology and John Wiley & Sons Ltd.)
- Subjects :
- Humans
Child
Tumor Burden
Fluorodeoxyglucose F18 metabolism
Positron-Emission Tomography methods
Risk Assessment
Prognosis
Retrospective Studies
Radiopharmaceuticals
Positron Emission Tomography Computed Tomography
Glycolysis
Hodgkin Disease diagnostic imaging
Hodgkin Disease drug therapy
Hodgkin Disease pathology
Subjects
Details
- Language :
- English
- ISSN :
- 1365-2141
- Volume :
- 201
- Issue :
- 6
- Database :
- MEDLINE
- Journal :
- British journal of haematology
- Publication Type :
- Academic Journal
- Accession number :
- 36922022
- Full Text :
- https://doi.org/10.1111/bjh.18734