Interim fluoro-2-deoxy-D-glucose-PET predicts response and progression-free survival in patients with Hodgkin lymphoma and HIV infection

TY - JOUR

T1 - Interim fluoro-2-deoxy-D-glucose-PET predicts response and progression-free survival in patients with Hodgkin lymphoma and HIV infection

AU - Okosun, Jessica

AU - Warbey, Victoria

AU - Shaw, Kate

AU - Montoto, Silvia

AU - Fields, Paul

AU - Marcus, Robert

AU - Virchis, Andres

AU - McNamara, Christopher

AU - Bower, Mark

AU - Cwynarski, Kate

PY - 2012/4/24

Y1 - 2012/4/24

N2 - Background: Interim PET scans in HIV-negative patients with Hodgkin lymphoma has emerged as one of the most important prognostic tools. However, equivalent studies in HIV-positive patients are yet to be performed. Objective: We evaluated the prognostic value of interim [18F]-fluoro-2-deoxy-D-glucose–PET (18F-FDG PET) after two or three cycles of chemotherapy using adriamycin, bleomycin, vinblastine and dacarbazine (ABVD) with concomitant HAART in HIV-positive patients with Hodgkin lymphoma. Methods: Patients with advanced HIV–Hodgkin lymphoma (HIV-HL) from six UK centres were included. Interim PET scans after two or three cycles of ABVD (PET-2 or PET-3) were carried out. Prognostic analysis correlated the 2-year progression-free survival (PFS) rate with the interim PET result. Results: Twenty-three evaluable patients were assessed, 21 achieved a negative interim PET and 22 achieved complete remission by computerized tomography scan criteria after ABVD therapy. After a median follow-up of 27 months (range 12–50), disease progression was seen in one patient. Treatment failure was seen in one of the two interim PET-positive patients and none of the interim PET-negative patients. The 2-year PFS for interim PET-positive patients was 50%, and 100% for interim PET-negative patients (P = 0.0012). Conclusion: A negative interim 18F-FDG PET result is highly predictive of treatment success in HIV-HL patients.

AB - Background: Interim PET scans in HIV-negative patients with Hodgkin lymphoma has emerged as one of the most important prognostic tools. However, equivalent studies in HIV-positive patients are yet to be performed. Objective: We evaluated the prognostic value of interim [18F]-fluoro-2-deoxy-D-glucose–PET (18F-FDG PET) after two or three cycles of chemotherapy using adriamycin, bleomycin, vinblastine and dacarbazine (ABVD) with concomitant HAART in HIV-positive patients with Hodgkin lymphoma. Methods: Patients with advanced HIV–Hodgkin lymphoma (HIV-HL) from six UK centres were included. Interim PET scans after two or three cycles of ABVD (PET-2 or PET-3) were carried out. Prognostic analysis correlated the 2-year progression-free survival (PFS) rate with the interim PET result. Results: Twenty-three evaluable patients were assessed, 21 achieved a negative interim PET and 22 achieved complete remission by computerized tomography scan criteria after ABVD therapy. After a median follow-up of 27 months (range 12–50), disease progression was seen in one patient. Treatment failure was seen in one of the two interim PET-positive patients and none of the interim PET-negative patients. The 2-year PFS for interim PET-positive patients was 50%, and 100% for interim PET-negative patients (P = 0.0012). Conclusion: A negative interim 18F-FDG PET result is highly predictive of treatment success in HIV-HL patients.

KW - adriamycin

KW - bleomycin

KW - fluoro-2-deoxy-D-glucose-PET

KW - HIV

KW - Hodgkin lymphoma

KW - vinblastine and dacarbazine therapy

KW - POSITRON-EMISSION-TOMOGRAPHY

KW - ACTIVE ANTIRETROVIRAL THERAPY

KW - ADVANCED-STAGE

KW - PROGNOSTIC SCORE

KW - DISEASE

KW - AIDS

KW - CHEMOTHERAPY

KW - REGIMEN

KW - VINBLASTINE

KW - DACARBAZINE

U2 - 10.1097/QAD.0b013e32835213b1

DO - 10.1097/QAD.0b013e32835213b1

M3 - Article

C2 - 22333746

SN - 0269-9370

VL - 26

SP - 861

EP - 865

JO - Aids

JF - Aids

IS - 7

ER -