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Focal skeletal FDG uptake indicates poor prognosis in cHL regardless of extent and first-line chemotherapy
Aarhus Univ Hosp, Dept Nucl Med, Aarhus, Denmark;Aarhus Univ Hosp, PET Ctr, Aarhus, Denmark.
Aarhus Univ Hosp, Dept Nucl Med, Aarhus, Denmark;Aarhus Univ Hosp, PET Ctr, Aarhus, Denmark.
Aarhus Univ Hosp, Dept Haematol, Palle Juul Jensens Blvd 99, DK-8200 Aarhus N, Denmark.
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Radiology.
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2019 (English)In: British Journal of Haematology, ISSN 0007-1048, E-ISSN 1365-2141, Vol. 186, no 3, p. 431-439Article in journal (Refereed) Published
Abstract [en]

F-18-fluoro-2-deoxy-D-glucose positron emission tomography/computed tomography (FDG-PET/CT) is used for staging classical Hodgkin lymphoma (cHL) with high sensitivity for skeletal involvement. However, it is unclear whether a single bone lesion carries the same adverse prognosis as multifocal lesions and if this is affected by type of chemotherapy [ABVD (adriamycin, bleomycin, vincristine, dacarbazine) versus BEACOPP (bleomycin, etoposide, adriamycin, cyclophosphamide, vincristine, procarbazine, prednisone)]. We reviewed the clinico-pathological and outcome data from 209 patients with newly diagnosed cHL staged by FDG-PET/CT. Patterns of skeletal/bone marrow uptake (BMU) were divided into 'low' and 'high' diffuse BMU (i.e. without focal lesions), and unifocal or multifocal lesions. Additional separate survival analysis was performed, taking type of chemotherapy into account. Forty patients (19 center dot 2%) had skeletal lesions (20 unifocal, 20 multifocal). The 3-year progression-free-survival (PFS) was 80% for patients with 'low BMU', 87% for 'high BMU', 69% for 'unifocal' and 51% for 'multifocal' lesions; median follow-up was 38 months. The presence of bone lesions, both uni- and multifocal, was associated with significantly inferior PFS (log rank P = 0 center dot 0001), independent of chemotherapy type. Thus, increased diffuse BMU should not be considered as a risk factor in cHL, whereas unifocal or multifocal bone lesions should be regarded as important predictors of adverse outcome, irrespective of the chemotherapy regimen used.

Place, publisher, year, edition, pages
WILEY , 2019. Vol. 186, no 3, p. 431-439
Keywords [en]
F-18-FDG PET, CT, classical Hodgkin lymphoma, bone marrow uptake, focal bone lesions, chemotherapy
National Category
Hematology Cancer and Oncology Clinical Laboratory Medicine
Research subject
Pathology
Identifiers
URN: urn:nbn:se:uu:diva-393747DOI: 10.1111/bjh.15933ISI: 000481501200007PubMedID: 31115045OAI: oai:DiVA.org:uu-393747DiVA, id: diva2:1369160
Available from: 2019-11-11 Created: 2019-11-11 Last updated: 2020-01-03Bibliographically approved

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Wassberg, CeciliaAmini, Rose-MarieEnblad, GunillaMolin, Daniel

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