Prognostic value of FDG-PET scan imaging in lymphoma patients undergoing autologous stem cell transplantation

Abstract
We conducted a retrospective analysis of 50 lymphoma patients (Hodgkin's disease and non-Hodgkin's lymphoma) who had an 18F-fluoro-deoxyglucose positron emission tomography (FDG-PET) scan after at least two cycles of salvage chemotherapy and before autologous stem cell transplantation (ASCT) at our institution. The patients were categorized into FDG-PET negative (N=32) and positive (N=18) groups. The median follow-up after ASCT was 19 months (range: 3–59). In the FDG-PET-negative group, the median progression-free survival (PFS) was 19 months (range: 2–59) with 15 (54%) patients without progression at 12 months after ASCT. The median overall survival (OS) for this group was not reached. In the FDG-PET-positive group, the median PFS was 5 months (range: 1–19) with only one (7%) patient without progression at 12 months after ASCT. The median OS was 19 months (range: 1–34). In the FDG-PET-negative group, chemotherapy-resistant patients by CT-based criteria had a comparable outcome to those with chemotherapy-sensitive disease. A positive FDG-PET scan after salvage chemotherapy and prior ASCT indicates an extremely poor chance of durable response after ASCT.

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