Universität zu Köln

Kobe, Carsten, Goergen, Helen, Baues, Christian, Kuhnert, Georg, Voltin, Conrad-Amadeus ORCID: 0000-0002-5437-3959, Zijlstra, Josee, Hoekstra, Otto, Mettler, Jasmin, Drzezga, Alexander, Engert, Andreas, Borchmann, Peter and Dietlein, Markus (2018). Outcome-based interpretation of early interim PET in advanced-stage Hodgkin lymphoma. Blood, 132 (21). S. 2273 - 2280. WASHINGTON: AMER SOC HEMATOLOGY. ISSN 1528-0020

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Abstract

The HD18 study for patients with newly diagnosed advanced-stage Hodgkin lymphoma (HL) used positron emission tomography (PET) after 2 cycles (PET-2) of bleomycin, etoposide, doxorubicin, cyclophosphamide, vincristine, procarbazine, and prednisone in escalated doses (eBEACOPP) to guide further treatment. Here, we analyzed the impact of PET-2 results in the context of eBEACOPP according to the Deauville score (DS) in patients treated within the HD18 trial. Residual tissue was visually compared with reference regions according to DS. We analyzed the association between PET-2 uptake and baseline characteristics, progression-free survival (PFS), and overall survival (OS). One thousand five patients (52%) had DS1 or DS2, 471 (24%) had DS3, and 469 (24%) DS4. PET-2 uptake was associated with baseline risk factors large mediastinal mass, extranodal disease, and high International Prognostic Score (P<.0001 each). Among 722 patients receiving standard therapy with 6 cycles of eBEACOPP, 3-year PFS rates were 92.2%, 95.9%, and 87.6% with DS1-2, DS3, and DS4, respectively. Univariate hazard ratio (HR) for PFS in patients with DS4 vs DS1-3 was 2.3 (1.3-3.8; P=.002). DS4 was the only factor remaining significant for PFS in a multivariate analysis including the associated baseline risk factors. Three-year OS rates were 97.6% for DS1-2, 99.0% for DS3, and 96.8% for DS4, with a univariate HR for DS4 vs DS1-3 of 2.6 (1.0-6.6; P=.04). Residual uptake above that in the liver at PET-2 (ie, DS4) is an important risk factor regarding survival outcomes for patients treated with eBEACOPP upfront. We thus recommend DS4 as the cutoff value for PET-2 positivity. This trial was registered at www.clinicaltrials.gov as #NCT00515554.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Kobe, Carsten UNSPECIFIED UNSPECIFIED UNSPECIFIED Goergen, Helen UNSPECIFIED UNSPECIFIED UNSPECIFIED Baues, Christian UNSPECIFIED UNSPECIFIED UNSPECIFIED Kuhnert, Georg UNSPECIFIED UNSPECIFIED UNSPECIFIED Voltin, Conrad-Amadeus UNSPECIFIED orcid.org/0000-0002-5437-3959 UNSPECIFIED Zijlstra, Josee UNSPECIFIED UNSPECIFIED UNSPECIFIED Hoekstra, Otto UNSPECIFIED UNSPECIFIED UNSPECIFIED Mettler, Jasmin UNSPECIFIED UNSPECIFIED UNSPECIFIED Drzezga, Alexander UNSPECIFIED UNSPECIFIED UNSPECIFIED Engert, Andreas UNSPECIFIED UNSPECIFIED UNSPECIFIED Borchmann, Peter UNSPECIFIED UNSPECIFIED UNSPECIFIED Dietlein, Markus UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-165452
DOI:	10.1182/blood-2018-05-852129
Journal or Publication Title:	Blood
Volume:	132
Number:	21
Page Range:	S. 2273 - 2280
Date:	2018
Publisher:	AMER SOC HEMATOLOGY
Place of Publication:	WASHINGTON
ISSN:	1528-0020
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language POSITRON-EMISSION-TOMOGRAPHY; RESPONSE-ADAPTED THERAPY; OPEN-LABEL; CHEMOTHERAPY; TRIAL; SCAN; ABVD; RADIOTHERAPY; SURVIVAL; BEACOPP Multiple languages Hematology Multiple languages
Refereed:	Yes
URI:	http://kups.ub.uni-koeln.de/id/eprint/16545