Prognostication and Risk-Adapted Therapy of Hodgkin's Lymphoma Using Positron Emission Tomography

Table 1

PET during first-line chemotherapy for Hodgkin’s lymphoma.

Study	Prospective	No.	Stage	Chemo, ±RT	Cycles before PET	No. PET+ (%)	PPV	NPV	EFS, PET+	EFS, PET–	Median follow-up
Friedberg et al. 2004 [28]	yes	22	I–IV; 28% III-IV	Mostly ABVD	3	5 (23%)	80%	94%	—	—	24 mo
Hutchings et al. 2005 [29]	no	85	I–IV; 33% III-IV	Mostly ABVD	2-3	13 (15%)^a	61.5%	94%	46% (2 y)	97% (2 y)	40 mo
									39% (5 y)	92% (5 y)
Gallamini et al. 2006 [34]	yes	108	IIA with RF, IIB-IV; 46% III-IV	Mostly ABVD	2	20 (19%)	90%	97%	6% (2 y)	96% (2 y)	20 mo (mean)
Hutchings et al. 2006 [30]	yes	77	I-IV; 36% III-IV	Mostly ABVD	2	16 (21%)^a	69%	95%	0% (2 y)	96% (2 y)	23 mo
		64			4	13 (20%)	85%	96%	19% (2 y)	96% (2 y)	23 mo
Zinzani et al. 2006 [32]	yes	40	IIB-IV; 48% III-IV	ABVD	2	8 (20%)^b	100%	100%	—	—	18 mo
		40			4	7 (18%)^b	100%	100%	—	—	18 mo
Kostakoglu et al. 2006 [25]	no	23	II–IV; 35% III-IV	ABVD	1	6 (26%)	83%	100%	17% (2 y)	100% (2 y)	20 mo
Querellou et al. 2006 [33]	no	44	IIA-IV; 63% III-IV	Mostly ABVD	3-4	---^c	—	95%^c	—	95% (1 y)	18 mo
Gallamini et al. 2007 [31]	yes	260^d	IIA with RF, IIB-IV; 47% III–IV	Mostly ABVD	2	50 (19%)^a	86%	95%	13% (2 y)	95% (2 y)	26 mo
Sher et al. 2009 [35]	no	46	Mostly I-II	ABVD-based^e	—	20 (43%)	15%	96%	85% (2 y)	96% (2 y)^f	—
Markova et al. 2009 [36]	no	50	IIB with RF, III–IV; 78% III–IV	BEACOPP	4	14 (28%)	14%^g	97%^h	86% (2 y)^g	97% (2 y)	25 mo
Furth et al. 2009 [37]	yes	40	I–IV; 48% III-IV	OEPA^i	2	14 (35%)	14%	100%	86% (4 y)	100% (4 y)	46 mo
Avigdor et al. 2009 [38]	yes	45	IIB-IV; 93% III–IV	BEACOPPesc × 2, then ABVD^j	2	13 (29%)	45%	87%	53% (4 y)	87% (4 y)	48 mo

ABVD: doxorubicin, bleomycin, vinblastine, dacarbazine; BEACOPP: bleomycin, etoposide, doxorubicin, cyclophosphamide, vincristine, procarbazine, prednisone; EFS: event-free survival; esc: escalated; MRU: minimal residual uptake; NPV: negative predictive value; OEPA: vincristine, etoposide, prednisone, doxorubicin; PPV: positive predictive value; RF: risk factor(s); RT: radiation therapy. Definition of an event variably includes relapse or progression, incomplete remission, disease-related death, and/or any death; starting points for EFS estimates vary. Table modified from Kasamon et al. [21].
^aMRU cases were analyzed with PET− cases.
^bMRU cases (4 after cycle 2 PET, 3 after cycle 4 PET) were analyzed separately; 1 relapsed.
^c4/24 patients were PET+, 1 being newly diagnosed; 18/20 PET− patients were newly diagnosed.
^dIncludes previously reported patients [30, 34].
^eAll received radiation.
^fFor interim and post-chemotherapy PET− disease; 1/26 was interim PET−, post-chemotherapy PET+.
^g7/14 received RT, which was restricted to >2.5 cm, PET+ masses on post-chemotherapy imaging.
^hIncludes 1 non-relapse death.
ⁱPediatric study; 98% received RT.
^jResponse-adapted study; with or without additional therapy.