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Clinical characteristics of interim-PET negative patients with a positive end PET from the prospective HD08-01 FIL study

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Abstract

FDG-positron emission tomography (PET) performed early during therapy in advanced Hodgkin lymphoma patients has been confirmed as being important for progression-free survival. A group of patients with a negative interim-PET (i-PET) showed a positive end induction PET (e-PET). The aim of this study was to evaluate the clinical characteristics of patients with a positive e-PET as a secondary end point of the HD0801 study. A total of 519 patients with advanced-stage de novo Hodgkin lymphoma received initial treatment and underwent an i-PET. Patients with negative results continued the standard treatment. i-PET negative patients were then evaluated for response with an e-PET and those patients found to have a positive one were also then given a salvage therapy. Among 409 i-PET negative, 16 interrupted the therapy, 393 patients were evaluated with an e-PET, and 39 were positive. Sixteen out of 39 underwent a diagnostic biopsy and 15 were confirmed as HD. Seventeen out of 39 e-PET were reviewed according to the Deauville Score and, in sixteen, it was confirmed positive (10 DS 5, 6 DS 4). With the exception of high LDH value at diagnosis (p = 0.01; HR 95% CI 1.18–4.89), no clinical characteristics were significantly different in comparison with e-PET negative patients. Positive e-PET after a negative i-PET has a worse outcome when compared with i-PET positive patients salvaged with therapy intensification. It was not possible to identify clinical characteristics associated with a positive e-PET.

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Materials are available upon request.

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Acknowledgments

The authors want to thank Mrs Lara Cox for the language revision of the manuscript.

Author information

Authors and Affiliations

  1. Department of Hematology, AOU Careggi, Florence, Italy

    Luigi Rigacci, Benedetta Puccini, Lara Mannelli & Sofia Kovalchuk

  2. Hematology Unit and Bone Marrow Transplant Unit, AO San Camillo Forlanini, Rome, Italy

    Luigi Rigacci

  3. Institute of Hematology “L. e A. Seràgnoli”, University of Bologna, Bologna, Italy

    Alessandro Broccoli & Pier Luigi Zinzani

  4. Department of Nuclear Medicine, Ospedale Santo Stefano, Prato, Italy

    Manjola Dona

  5. Policlinico San Matteo Pavia Fondazione, IRCCS, Pavia, Italy

    Manuel Gotti & Maurizio Bonfichi

  6. Unit of Cancer Epidemiology, AO Città della Salute e della Scienza di Torino and FIL Secretary, Turin, Italy

    Andrea Evangelista & Daniela Gioia

  7. Humanitas Cancer Center, IRCCS, Rozzano, Italy

    Armando Santoro

  8. Department of Hematology, Spedali Civili, Brescia, Italy

    Alessandro Re & Chiara Pagani

  9. Oncology Centre of Reference, Aviano, Italy

    Michele Spina

  10. Hematology, Azienda Ospedaliero Universitaria Città della Salute e della Scienza di Torino, Turin, Italy

    Barbara Botto

  11. Institute of Haematology, Catholic University, Rome, Italy

    Alessandro Pulsoni

  12. Hematology Ospedale Bianchi Melacrino Morelli, Reggio Calabria, Italy

    Caterina Stelitano

  13. Division of Hematology, A.O. SS Antonio e Biagio e Cesare Arrigo, Alessandria, Italy

    Flavia Salvi

  14. Division of Hematology, Department of Translational Medicine, University of Eastern Piedmont, Novara, Italy

    Luca Nassi

Authors
  1. Luigi Rigacci
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  2. Benedetta Puccini
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  3. Alessandro Broccoli
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  4. Manjola Dona
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  18. Sofia Kovalchuk
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  20. Pier Luigi Zinzani
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Contributions

Conception and design: R.L., Z.PL.

Provision of study materials or patients: R.L., P.B., B.A., D.M., G.M., E.A., S.A., B.M., R.A., S.M., B.B., P.A., P.C., S.C., S.F., N.L., M.L., K.S., G.D., Z.P.

Collection and assembly of data: R.L., P.B., B.A., D.M., G.M., E.A., S.A., B.M., R.A., S.M., B.B., P.A., P.C., S.C., S.F., N.L., M.L., K.S., G.D., Z.PL.

Data analysis and interpretation: R.L., P.B., B.A., E.A., M.L., K.S.,Z.PL.

Manuscript writing: all authors

Final approval of manuscript: all authors

Corresponding author

Correspondence to Luigi Rigacci.

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Competing interests

The authors declare that they have no competing interests

Ethics approval and consent to participate

Patients signed informed consent, after internal institutional review board approval, to participate at the clinical study.

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Rigacci, L., Puccini, B., Broccoli, A. et al. Clinical characteristics of interim-PET negative patients with a positive end PET from the prospective HD08-01 FIL study. Ann Hematol 99, 283–291 (2020). https://doi.org/10.1007/s00277-019-03889-3

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  • DOI: https://doi.org/10.1007/s00277-019-03889-3

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