Subject(s)
Antibodies, Monoclonal, Humanized/adverse effects , Antineoplastic Agents, Immunological/adverse effects , Leukoencephalopathy, Progressive Multifocal/diagnosis , Lymphoma, Follicular/drug therapy , Neoplasm Recurrence, Local/drug therapy , Aged , Brain/diagnostic imaging , Brain/pathology , DNA, Viral/isolation & purification , Fatal Outcome , Female , Humans , Immunocompromised Host , JC Virus/genetics , JC Virus/immunology , JC Virus/isolation & purification , Leukoencephalopathy, Progressive Multifocal/blood , Leukoencephalopathy, Progressive Multifocal/chemically induced , Leukoencephalopathy, Progressive Multifocal/immunology , Lymphoma, Follicular/immunology , Magnetic Resonance Imaging , Neoplasm Recurrence, Local/immunologyABSTRACT
AIM: To examine the real-life impact of baseline positron-emission tomography/computed tomography (PET/CT) in Hodgkin lymphoma (HL). PATIENTS AND METHODS: A total of 162 consecutive patients with HL were retrospectively studied. RESULTS: Disease was up-staged in 26 patients (16%) and down-staged in 9 (6%). However, treatment strategy was modified in only 10 patients (6% of total). Involved field radiotherapy was delineated according to PET/CT in 36/66 patients (59%). These treatment modifications did not significantly affect outcome. Moreover, three potent prognostic parameters were identified: the number of involved sites, maximum standardized uptake value (SUVmax), and the product of SUVmax and maximal largest lesion diameter, as a surrogate of total lesion glycolysis. All three significantly correlated with 5-year freedom from disease progression p=0.004, p=0.009 and p=0.04, respectively). CONCLUSION: Baseline PET/CT findings may lead to treatment modification in <15% of patients with HL without a significant impact on outcome. Certain PET/CT parameters have potent prognostic significance.
