Prognostic value of TARC and quantitative PET parameters in relapsed or refractory Hodgkin lymphoma patients treated with brentuximab vedotin and DHAP.
Julia DriessenMarie José KerstenLydia VisserAnke van den BergSanne H ToninoJosée M ZijlstraPieternella J LugtenburgJudith TrotmanMartin HutchingsSandy AmorimThomas GastinneMarcel NijlandGerben J C ZwezerijnenRonald BoellaardHenrica C W de VetAnne I J ArensRoelf ValkemaRoberto D K LiuEsther E E DreesDaphne de JongWouter J PlattelArjan Diepstranull nullPublished in: Leukemia (2022)
Risk-stratified treatment strategies have the potential to increase survival and lower toxicity in relapsed/refractory classical Hodgkin lymphoma (R/R cHL) patients. This study investigated the prognostic value of serum (s)TARC, vitamin D and lactate dehydrogenase (LDH), TARC immunohistochemistry and quantitative PET parameters in 65 R/R cHL patients who were treated with brentuximab vedotin (BV) and DHAP followed by autologous stem-cell transplantation (ASCT) within the Transplant BRaVE study (NCT02280993). At a median follow-up of 40 months, the 3-year progression free survival (PFS) was 77% (95% CI: 67-88%) and the overall survival was 95% (90-100%). Significant adverse prognostic markers for progression were weak/negative TARC staining of Hodgkin Reed-Sternberg cells in the baseline biopsy, and a high standard uptake value (SUV)mean or SUVpeak on the baseline PET scan. After one cycle of BV-DHAP, sTARC levels were strongly associated with the risk of progression using a cutoff of 500 pg/ml. On the pre-ASCT PET scan, SUVpeak was highly prognostic for progression post-ASCT. Vitamin D, LDH and metabolic tumor volume had low prognostic value. In conclusion, we established the prognostic impact of sTARC, TARC staining, and quantitative PET parameters for R/R cHL, allowing the use of these parameters in prospective risk-stratified clinical trials. Trial registration: NCT02280993.
Keyphrases
- hodgkin lymphoma
- computed tomography
- free survival
- positron emission tomography
- pet ct
- stem cell transplantation
- clinical trial
- pet imaging
- high resolution
- newly diagnosed
- ejection fraction
- high dose
- end stage renal disease
- magnetic resonance imaging
- phase ii
- stem cells
- study protocol
- signaling pathway
- cell death
- chronic kidney disease
- cell cycle arrest
- phase iii
- randomized controlled trial
- climate change
- acute lymphoblastic leukemia
- platelet rich plasma
- pi k akt
- double blind
- breast cancer risk