Gary Allan Ulaner MD, PhD, Presenter: Research support, General Electric Company Research support, Seragon Pharmaceuticals, Inc

Debra A. Goldman MS, Abstract Co-Author: Nothing to Disclose

Joshua Lilienstein MD, Abstract Co-Author: Nothing to Disclose

Mithat Gonen PhD, Abstract Co-Author: Nothing to Disclose

Jocelyn Maragulia BA, Abstract Co-Author: Nothing to Disclose

Determine the value of FDG PET/CT prior to allogeneic and autologous stem cell transplant (SCT) of lymphoma patients in predicting outcome following transplant.

A retrospective review was performed under IRB waiver. Patients who underwent allogeneic or autologous SCT for lymphoma at our institution from 2005-2010, and had FDG PET/CT within 3 months before transplant, were included. PET/CT examinations were evaluated for suspicious lesions with FDG-avidity greater than liver background (Deauville 4/5). Clinical records were used to document overall survival (OS), disease specific survival (DSS), and progression free survival (PFS). The relationship between pre-transplant PET/CT and outcome was assessed using Kaplan-Meier methods and log-rank test separately for each group. The relationship between SUVmax and PFS was assessed using a piecewise linear univariate Cox regression in time.

273 patients were identified, 114 with FDG PET/CT prior to allogeneic SCT and 159 with FDG PET/CT prior to autologous SCT. Prior to SCT, 33 of 114 (29%) allogeneic patients and 21 of 159 (13%) autologous patients had suspicious FDG-avid lesions. For both allogeneic and autologous SCT patients, there was a significant relationship between suspicious FDG avid lesions and PFS (p=0.01 and p<0.0001). In allogeneic cases, the 2 year PFS estimates were 70±5% for FDG negative cases, but only 42±9% for FDG positive cases. In autologous cases, the 2 year PFS estimates were 70±4% for FDG negative cases, but only 24±9% for FDG-avid cases. Similar differences were seen in OS and DSS for both groups of patients. The higher the SUVmax of lesions before allogeneic or autologous transplant, the greater the risk of progression is for the first 12 months post transplant (p=0.0002 and p<0.0001). This relationship was not sustained after 12 months.

The presence of suspicious FDG-avid lesions on PET/CT prior to both allogeneic and autologous SCT identifies lymphoma patients where transplant has a low likelihood of sustained success. The higher the SUVmax of lesions, the greater the risk of recurrence is for the first 12 months following transplant.

FDG PET/CT prior to both allogeneic and autologous SCT predicts the likelihood of transplant success in aggressive lymphomas. PET/CT can help guide selection of patients for both of these procedures.

Ulaner, G, Goldman, D, Lilienstein, J, Gonen, M, Maragulia, J, Predictive Value of FDG PET/CT prior to Allogeneic and Autologous Stem Cell Transplant for Lymphoma.  Radiological Society of North America 2014 Scientific Assembly and Annual Meeting, - ,Chicago IL. http://archive.rsna.org/2014/14015160.html