The predictive role of interim positron emission tomography for Hodgkin lymphoma treatment outcome is confirmed using the interpretation criteria of the Deauville five-point scale

Andrea Gallamini, Sally F Barrington, Alberto Biggi, Stephane Chauvie, Lale Kostakoglu, Michele Gregianin, Michel Meignan, George N Mikhaeel, Annika Loft, Jan M Zaucha, John F Seymour, Michael S Hofman, Luigi Rigacci, Alessandro Pulsoni, Morton Coleman, Eldad J Dann, Livio Trentin, Olivier Casasnovas, Chiara Rusconi, Pauline BriceSilvia Bolis, Simonetta Viviani, Flavia Salvi, Stefano Luminari, Martin Hutchings

209 Citations (Scopus)

Abstract

A retrospective, international, multicenter study was undertaken to assess: (i) the prognostic role of 'interim' positron emission tomography performed during treatment with doxorubicin, bleomycin, vinblastine and dacarbazine in patients with Hodgkin lymphoma; and (ii) the reproducibility of the Deauville five-point scale for the interpretation of interim positron emission tomography scan. Two hundred and sixty patients with newly diagnosed Hodgkin lymphoma were enrolled. Fifty-three patients with early unfavorable and 207 with advanced-stage disease were treated with doxorubicin, bleomycin, vinblastine and dacarbazine ± involved-field or consolidation radiotherapy. Positron emission tomography scan was performed at baseline and after two cycles of chemotherapy. Treatment was not changed according to the results of the interim scan. An international panel of six expert reviewers independently reported the scans using the Deauville five-point scale, blinded to treatment outcome. Forty-five scans were scored as positive (17.3%) and 215 (82.7%) as negative. After a median follow up of 37.0 (2-110) months, 252 patients are alive and eight have died. The 3-year progression-free survival rate was 83% for the whole study population, 28% for patients with interim positive scans and 95% for patients with interim negative scans (P<0.0001). The sensitivity, specificity, and negative and positive predictive values of interim positron emission tomography scans for predicting treatment outcome were 0.73, 0.94, 0.94 and 0.73, respectively. Binary concordance amongst reviewers was good (Cohen's kappa 0.69-0.84). In conclusion, the prognostic role and validity of the Deauville five-point scale for interpretation of interim positron emission tomography scans have been confirmed by the present study.

Original languageEnglish
JournalHaematologica
Volume99
Issue number6
Pages (from-to)1107-13
Number of pages7
ISSN0390-6078
DOIs
Publication statusPublished - Jun 2014

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