Impact of PET-CT status on progression-free survival for relapsed follicular lymphoma patients undergoing autologous stem cell transplant
AuthorsEyre, T. A.
Barrington, S. F.
Pearce, R. M.
Crawley, C. R.
Townsend, W. M.
AffiliationDepartment of Haematology, Churchill Hospital, Oxford University Hospitals NHS Foundation Trust, Oxford
MetadataShow full item record
AbstractThe optimum management approach for patients with relapsed or refractory (R/R) follicular lymphoma (FL) remains uncertain. Autologous stem cell transplantation (autoSCT) is considered a standard option in suitable, younger patients with relapsed FL. AutoSCT is associated with very durable remissions in a minority but also significant, wellestablished toxicities. Although PET status pre-autoSCT is established in diffuse large B-cell lymphoma and Hodgkin lymphoma, no data exists in FL. We describe survival outcomes according to pre-autoSCT PET status according to Lugano criteria (complete metabolic remission (CMR) vs non-CMR) in 172 R/R FL patients within a national, multicentre, retrospective BSBMTCT registry study. Median number of prior lines pre-autoSCT was 3 (range 1-6). Median follow-up post-autoSCT was 27 months (range 3-70). Median progression-free survival (PFS) for all patients post-autoSCT was 28 months (interquartile range 23-36). There was no interaction between age at autoSCT, sex, number of months since last relapse, Karnofsky performance status or comorbidity index (HCT-CI) and achieving CMR pre-autoSCT. Superior progression-free survival was observed in 115 (67%) patients obtaining CMR versus 57 (33%) non-CMR patients (3-year PFS 50% vs. 22%, p=0.011) and by Deauville score pre-autoSCT (continuous variable 1-5, hazard ratio (HR) 1.32, p=0.049). PETstatus was independently associated with PFS (non-CMR HR 2.02, p=0.003), overall survival (non-CMR HR 3.08, p=0.010) and risk for relapse (non-CMR HR 1.64, p=0.046) post autoSCT by multivariable analysis. Our data suggests PET-status pre-autoSCT provides clear prognostic value and may help improve patient selection for autoSCT.
CitationEyre TA, Barrington SF, Okosun J, Abamba C, Pearce RM, Lee J, et al. Impact of PET-CT status on progression-free survival for relapsed follicular lymphoma patients undergoing autologous stem cell transplant. Haematologica. Ferrata Storti Foundation (Haematologica); 2022.