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The role of F-18 FDG PET/CT in evaluating the impact of HIV infection on tumor burden and therapy outcome in patients with Hodgkin lymphoma

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European Journal of Nuclear Medicine and Molecular Imaging Aims and scope Submit manuscript

Abstract

Background

To evaluate the impact of HIV infection on tumor burden and therapy outcome following treatment with chemotherapy in patients with Hodgkin lymphoma.

Methods

A total of 136 patients with classical Hodgkin lymphoma were studied (mean age ± SD = 32.31 ± 1.39 years, male = 86, female = 50). Advanced disease (stage III and IV) was present in 64% of patients. HIV infection was present in 57 patients while 79 patients were HIV-negative. Baseline F-18 FDG PET/CT was obtained in all patients. SUVmax, MTV and TLG were determined on the baseline scan to evaluate for tumor burden. All patients completed a standard regimen of adriamycin, bleomycin, vinblastine and dacarbazine (ABVD). After a median period of 8 weeks (range = 6 to 17 weeks), a repeat F-18 FDG PET/CT scan was obtained to evaluate response to therapy using Deauville 5-point scoring system.

Results

The HIV-positive and HIV-negative groups were similar with regards to age and disease stage. The groups were heterogeneous with respect to gender (p = 0.029). The SUVmax, MTV and TLG of lesions were not significant different between the two groups. Complete response was seen in 72.8% of the study population. Presence of HIV infection was associated with higher rate of treatment failure with 40.4% of the HIV-positive patients having treatment failure while only 17.7% of the HIV-negative patients had treatment failure (p = 0.0034). HIV infection was a significant predictor of response to chemotherapy. Effects of SUVmax, MTV, TLG and Ann Arbor stage of the disease were not statistically significant as predictors of therapy outcome. In a multiple logistic regression, presence of HIV infection still remained an independent predictor of therapy outcome in the presence of other factors such as SUVmax, MTV, TLG and the Ann Arbor stage of the disease.

Conclusions

HIV infection is not associated with a higher tumor burden in patients with Hodgkin lymphoma. HIV infection is, however, a strong predictor of poor therapy outcome in patients treated with standard regimen of ABVD.

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Acknowledgements

Departments of Nuclear Medicine at University of Pretoria and Inkosi Albert Luthuli Hospital.

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Authors and Affiliations

  1. Department of Nuclear Medicine, University of Pretoria and Steve Biko Academic Hospital, Private Bag X169, Pretoria, 0001, South Africa

    Ismaheel O. Lawal, Moshe R. Modiselle, Alfred O. Ankrah, Neo P. Mokgoro, Tebatso G. Boshomane, Christophe Van de Wiele & Mike M. Sathekge

  2. Department of Nuclear Medicine, Inkosi Albert Lithuli Central Hospital, Durban, South Africa

    Nozipho E. Nyakale, Lerwine M. Harry & Alphonse P. Msomi

  3. KVNR Nuclear and Molecular Imaging, Pretoria, South Africa

    Moshe R. Modiselle

  4. Department of Nuclear Medicine and Molecular Imaging, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands

    Alfred O. Ankrah

  5. Department of Radiology and Nuclear Medicine, University Ghent, Ghent, Belgium

    Christophe Van de Wiele

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  1. Ismaheel O. Lawal
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  2. Nozipho E. Nyakale
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  10. Mike M. Sathekge
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Correspondence to Mike M. Sathekge.

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The authors declare that they have no conflicts of interest.

Ethical approval

This study was performed in accordance with the ethical standard of our institutions and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.

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Informed consent was obtained from all individual participants included in the study.

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Lawal, I.O., Nyakale, N.E., Harry, L.M. et al. The role of F-18 FDG PET/CT in evaluating the impact of HIV infection on tumor burden and therapy outcome in patients with Hodgkin lymphoma. Eur J Nucl Med Mol Imaging 44, 2025–2033 (2017). https://doi.org/10.1007/s00259-017-3766-5

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  • DOI: https://doi.org/10.1007/s00259-017-3766-5

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