Journal of Blood & Lymph

Prognostic value of interim and end of treatment pet/ct scan results in pediatric Hodgkinâ??s lymphoma

Abstract

Mohyeldin Saber Abdehlalim

Statement of the Problem:
Treating pediatric Hodgkin lymphoma (HL) involves a delicate balance between cure and reducing late toxicity. Fluorodeoxyglucose positron emission tomography (PET) combined with computed tomography (CT) identifies patients with early response to chemotherapy, for whom radiotherapy may be avoided. The role of PET-CT in upfront risk stratification and response–adapted treatment is evaluated in this study. Methodology & Theoretical Orientation: Patients with HL, who were younger than 18 years, were included. PET-CT was performed at baseline and after two cycles of chemotherapy. Patients were stratified into three risk groups: group 1 (stage I or II with no unfavorable features); group2 (stage I or II with bulky disease/B symptoms); and group3 (stage III/IV). A doxorubicin, bleomycin, vinblastine, dacarbazine–based regimen was used in early disease. A cyclophosphamide, vincristine, prednisolone, procarbazine, doxorubicin, bleomycin, vinblastine–based regimen was used in advanced disease.

Findings:
Forty-nine patients were included. Fifteen (31%), seven (14%), and 27 (55%) patients were included in groups 1, 2, and 3, respectively. Among 36 patients who underwent staging by PET-CT at diagnosis, seven (19%) patients were upstaged and one (3%) patient was downstaged by PET compared with CT. On the basis of negative interim PET responses, 39 (80%) patients were treated without radiotherapy. The 3-year event-free survival for the entire cohort was 91 %( 65.2%) and overall survival was 100%.

Conclusion & Significance:
PET-CT is an excellent stand-alone staging modality in HL. The omission of radiotherapy can be considered in patients who achieve metabolic remission on interim PET.

Biography:
Agokeng Demanou Sylvie is a PhD student of chemical pathology at the University of Buea, aged of 36 years. She is quality control manager at the Blood bank of the Bertoua regional Hospital. Before her work in public service she served as project manager in the project Kaposi’s sarcoma in Cameroon at Sochimio. Actually working on a project entitles soluble transferrin receptor in the diagnosis of iron deficiency anaemia in children.

PDF