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Yadgarov MY, Dunaykin MM, Shestopalov GI, Kailash C, Kireeva ED, Myakova NV, Likar YN. Prognostic value of baseline and interim [ 18F]FDG PET metabolic parameters in pediatric Hodgkin's lymphoma. Eur J Nucl Med Mol Imaging 2024; 51:1955-1964. [PMID: 38351389 DOI: 10.1007/s00259-024-06643-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2023] [Accepted: 02/05/2024] [Indexed: 05/31/2024]
Abstract
BACKGROUND Hodgkin lymphoma (HL) in pediatric populations has a high survival rate but poses risks for long-term morbidities. Although [18F]fluoro‑2‑deoxy‑2‑d‑glucose positron emission tomography ([18F]FDG PET) scans offer potential for improved risk stratification, the definitive prognostic value of quantitative [18F]FDG PET parameters remains unclear for pediatric HL. METHODS A single-center, retrospective study included pediatric patients diagnosed with HL between 2016 and 2023 treated according to EuroNet-PHL-C1 and DAL/GPOH-HD protocols. Patients underwent baseline and interim PET/CT scans after two chemotherapy cycles. Event-free survival (EFS) was the primary endpoint, Deauville score was the secondary endpoint. Quantitative [18F]FDG PET parameters included SUVmax, metabolic tumor volume (MTV) and total lesion glycolysis (TLG) that were evaluated using two segmentation methods (SUV 2.5, 41% SUVmax). Survival outcomes were assessed using Cox regression analysis. RESULTS A total of 115 patients (50 males, median age 14.2 years) were studied, with a median follow-up period of 35 months. During this period, 16 cases (13.9%) of relapse or progression were noted. Baseline and interim MTV 2.5, MTV 41%, TLG 2.5, and TLG 41%, along with interim SUVmax, were significantly associated with worse EFS and correlated with post-treatment Deauville scores. In multivariable analysis, interim MTV 2.5 > 0 ml (adj. hazard ratio, HR: 3.89, p = 0.009) and interim TLG 41% ≥ 30 g (adj. HR: 7.98, p = 0.006) were independent risk factors for EFS. CONCLUSION Baseline and interim [18F]FDG PET parameters can serve as significant prognostic indicators for EFS and treatment response in pediatric HL. These quantitative measures could enhance individualized, risk-adapted treatment strategies for children and adolescents with HL.
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Affiliation(s)
- Mikhail Ya Yadgarov
- Dmitry Rogachev National Medical Research Center of Pediatric Hematology, Oncology and Immunology, Moscow, Russia.
- Department of PET and Radionuclide Diagnostics, Dmitry Rogachev National Medical Research Center of Pediatric Hematology, Oncology and Immunology, Samory Mashela Str. 1, 117997, Moscow, Russia.
| | - M M Dunaykin
- Dmitry Rogachev National Medical Research Center of Pediatric Hematology, Oncology and Immunology, Moscow, Russia
| | - G I Shestopalov
- Dmitry Rogachev National Medical Research Center of Pediatric Hematology, Oncology and Immunology, Moscow, Russia
- Russian Children's Clinical Hospital, N.I. Pirogov Russian National Research Medical University of the Ministry of Health of the Russian Federation, Moscow, Russia
| | - C Kailash
- Dmitry Rogachev National Medical Research Center of Pediatric Hematology, Oncology and Immunology, Moscow, Russia
| | - E D Kireeva
- Dmitry Rogachev National Medical Research Center of Pediatric Hematology, Oncology and Immunology, Moscow, Russia
| | - N V Myakova
- Dmitry Rogachev National Medical Research Center of Pediatric Hematology, Oncology and Immunology, Moscow, Russia
| | - Yu N Likar
- Dmitry Rogachev National Medical Research Center of Pediatric Hematology, Oncology and Immunology, Moscow, Russia
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Zhu YM, Peng P, Liu X, Qi SN, Wang SL, Fang H, Song YW, Liu YP, Jin J, Li N, Lu NN, Jing H, Tang Y, Chen B, Zhang WW, Zhai YR, Yang Y, Liang B, Zheng R, Li YX. Optimizing the prognostic capacity of baseline 18F-FDG PET/CT metabolic parameters in extranodal natural killer/T-cell lymphoma by using relative and absolute thresholds. Heliyon 2024; 10:e25184. [PMID: 38322946 PMCID: PMC10844272 DOI: 10.1016/j.heliyon.2024.e25184] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2023] [Revised: 01/19/2024] [Accepted: 01/22/2024] [Indexed: 02/08/2024] Open
Abstract
Objectives To investigate the prognostic capacity of baseline 18F-fluorodeoxyglucose (18F-FDG) positron emission tomography/computed tomography (PET/CT) metabolic parameters in extranodal natural killer/T-cell lymphoma (ENKTCL), and the influence of relative thresholds (RT) and absolute thresholds (AT) selection on prognostic capacity. Materials and methods Metabolic tumor volume (MTV)-based parameters were defined using RTs (41 % or 25 % of maximum standardized uptake value [SUVmax]), ATs (SUV 2.5, 3.0, 4.0, or mean liver uptake) in 133 patients. Metabolic parameters were classified into avidity-related parameters (SUVmax, mean SUV [SUVmean], standard deviation of SUV [SUVsd]), volume-related parameters (RT-MTV), and avidity- and volume-related parameters (total lesion glycolysis [TLG] and AT-MTV). The prognostic capacity of the metabolic parameters and the effects of different threshold types (RT vs. AT) were evaluated. Results All metabolic parameters were moderately associated with prognosis. However, the area under the receiver operating characteristic curve of MTV and TLG was slightly higher than that of avidity-related parameters for predicting 5-year progression-free survival (PFS) (0.614-0.705 vs. 0.563-0.609) and overall survival (OS) (0.670-0.748 vs. 0.562-0.593). Correlations of MTV and avidity-related parameters differed between RTs (r < 0.06, P = 0.324-0.985) and ATs (r 0.56-0.84, P ≤ 0.001). AT-MTV was the optimal predictor for PFS and OS, while RT-TLG was the optimal predictor for PFS, and the combination of RT-MTV with SUVmax was the optimal predictor for OS. Conclusion The incorporation of volume and avidity significantly improved the prognostic capacity of PET in ENKTCL. Composite parameters that encompassed both avidity and volume were recommended.
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Affiliation(s)
- Ying-Ming Zhu
- Department of Radiation Oncology, National Cancer Center/Cancer Hospital, Chinese Academy of Medical Sciences (CAMS) and Peking Union Medical College (PUMC), Beijing, China
| | - Pan Peng
- Department of Nuclear Medicine, National Cancer Center/Cancer Hospital, CAMS and PUMC, Beijing, China
| | - Xin Liu
- Department of Radiation Oncology, National Cancer Center/Cancer Hospital, Chinese Academy of Medical Sciences (CAMS) and Peking Union Medical College (PUMC), Beijing, China
| | - Shu-Nan Qi
- Department of Radiation Oncology, National Cancer Center/Cancer Hospital, Chinese Academy of Medical Sciences (CAMS) and Peking Union Medical College (PUMC), Beijing, China
| | - Shu-Lian Wang
- Department of Radiation Oncology, National Cancer Center/Cancer Hospital, Chinese Academy of Medical Sciences (CAMS) and Peking Union Medical College (PUMC), Beijing, China
| | - Hui Fang
- Department of Radiation Oncology, National Cancer Center/Cancer Hospital, Chinese Academy of Medical Sciences (CAMS) and Peking Union Medical College (PUMC), Beijing, China
| | - Yong-Wen Song
- Department of Radiation Oncology, National Cancer Center/Cancer Hospital, Chinese Academy of Medical Sciences (CAMS) and Peking Union Medical College (PUMC), Beijing, China
| | - Yue-Ping Liu
- Department of Radiation Oncology, National Cancer Center/Cancer Hospital, Chinese Academy of Medical Sciences (CAMS) and Peking Union Medical College (PUMC), Beijing, China
| | - Jing Jin
- Department of Radiation Oncology, National Cancer Center/Cancer Hospital, Chinese Academy of Medical Sciences (CAMS) and Peking Union Medical College (PUMC), Beijing, China
- Department of Radiation Oncology, National Cancer Center/Cancer Hospital & Shenzhen Hospital, CAMS and PUMC, Shenzhen, China
| | - Ning Li
- Department of Radiation Oncology, National Cancer Center/Cancer Hospital, Chinese Academy of Medical Sciences (CAMS) and Peking Union Medical College (PUMC), Beijing, China
| | - Ning-Ning Lu
- Department of Radiation Oncology, National Cancer Center/Cancer Hospital, Chinese Academy of Medical Sciences (CAMS) and Peking Union Medical College (PUMC), Beijing, China
| | - Hao Jing
- Department of Radiation Oncology, National Cancer Center/Cancer Hospital, Chinese Academy of Medical Sciences (CAMS) and Peking Union Medical College (PUMC), Beijing, China
| | - Yuan Tang
- Department of Radiation Oncology, National Cancer Center/Cancer Hospital, Chinese Academy of Medical Sciences (CAMS) and Peking Union Medical College (PUMC), Beijing, China
| | - Bo Chen
- Department of Radiation Oncology, National Cancer Center/Cancer Hospital, Chinese Academy of Medical Sciences (CAMS) and Peking Union Medical College (PUMC), Beijing, China
| | - Wen-Wen Zhang
- Department of Radiation Oncology, National Cancer Center/Cancer Hospital, Chinese Academy of Medical Sciences (CAMS) and Peking Union Medical College (PUMC), Beijing, China
| | - Yi-Rui Zhai
- Department of Radiation Oncology, National Cancer Center/Cancer Hospital, Chinese Academy of Medical Sciences (CAMS) and Peking Union Medical College (PUMC), Beijing, China
| | - Yong Yang
- Department of Radiation Oncology, National Cancer Center/Cancer Hospital, Chinese Academy of Medical Sciences (CAMS) and Peking Union Medical College (PUMC), Beijing, China
- Department of Radiation Oncology, Fujian Medical University Union Hospital, Fuzhou, China
| | - Bin Liang
- Department of Radiation Oncology, National Cancer Center/Cancer Hospital, Chinese Academy of Medical Sciences (CAMS) and Peking Union Medical College (PUMC), Beijing, China
| | - Rong Zheng
- Department of Nuclear Medicine, National Cancer Center/Cancer Hospital, CAMS and PUMC, Beijing, China
| | - Ye-Xiong Li
- Department of Radiation Oncology, National Cancer Center/Cancer Hospital, Chinese Academy of Medical Sciences (CAMS) and Peking Union Medical College (PUMC), Beijing, China
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De Re V, Lopci E, Brisotto G, Elia C, Mussolin L, Mascarin M, d’Amore ESG. Preliminary Study of the Relationship between Osteopontin and Relapsed Hodgkin's Lymphoma. Biomedicines 2023; 12:31. [PMID: 38275392 PMCID: PMC10813762 DOI: 10.3390/biomedicines12010031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2023] [Revised: 12/06/2023] [Accepted: 12/07/2023] [Indexed: 01/27/2024] Open
Abstract
The primary objective of this study was to investigate the potential role of tissue osteopontin, also known as secreted phosphoprotein 1 (SPP1), as a contributing factor to an unfavorable prognosis in classical Hodgkin's lymphoma (HL) patients who received the same treatment protocol. The study involved 44 patients aged 4-22 years, with a median follow-up period of 3 years. Patients with higher levels of SPP1 were associated with tissue necrosis and inflammation, and there was a trend toward a poorer prognosis in this group. Before therapy, we found a correlation between positron emission tomography (PET) scans and logarithmic SPP1 levels (p = 0.035). However, the addition of SPP1 levels did not significantly enhance the predictive capacity of PET scans for recurrence or progression. Elevated SPP levels were associated with tissue mRNA counts of chemotactic and inflammatory chemokines, as well as specific monocyte/dendritic cell subtypes, defined by IL-17RB, PLAUR, CXCL8, CD1A, CCL13, TREM1, and CCL24 markers. These findings contribute to a better understanding of the potential factors influencing the prognosis of HL patients and the potential role of SPP1 in the disease. While the predictive accuracy of PET scans did not substantially improve during the study, the results underscore the complexity of HL and highlight the relationships between SPP1 and other factors in the context of HL relapse.
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Affiliation(s)
- Valli De Re
- Immunopatologia e Biomarcatori Oncologici, CRO Aviano, National Cancer Institute, Istituto di Ricovero e Cura a Carattere Scientifico, IRCCS, 33081 Aviano, Italy
| | - Egesta Lopci
- Nuclear Medicine Unit, IRCCS—Humanitas Research Hospital, Rozzano, 20089 Milano, Italy
| | - Giulia Brisotto
- Immunopatologia e Biomarcatori Oncologici, CRO Aviano, National Cancer Institute, Istituto di Ricovero e Cura a Carattere Scientifico, IRCCS, 33081 Aviano, Italy
| | - Caterina Elia
- AYA Oncology and Pediatric Radiotherapy Unit, CRO Aviano, National Cancer Institute, Istituto di Ricovero e Cura a Carattere Scientifico, IRCCS, 33081 Aviano, Italy
| | - Lara Mussolin
- Pediatric Hemato-Oncology Unit, Department of Women’s and Children’s Health, University of Padua, 35122 Padua, Italy
- Clinica di Oncoematologia Pediatrica, Azienda Ospedaliera—Università di Padova, 35128 Padova, Italy
| | - Maurizio Mascarin
- AYA Oncology and Pediatric Radiotherapy Unit, CRO Aviano, National Cancer Institute, Istituto di Ricovero e Cura a Carattere Scientifico, IRCCS, 33081 Aviano, Italy
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Stankiewicz J, Kołtan A, Demidowicz E, Bartoszewicz N, Kołtan S, Czyżewski K, Richert-Przygońska M, Dębski R, Pogorzała M, Tejza B, Cisek J, Księżniakiewicz P, Jatczak-Gaca A, Marjańska A, Salamon M, Dąbrowska A, Urbańczyk A, Grześk E, Jaremek K, Łęcka M, Grochowska O, Styczyński J. Therapy results in pediatric Hodgkin lymphoma - does less mean better? Experience from a single children's oncology center. Ann Hematol 2023:10.1007/s00277-023-05268-5. [PMID: 37195291 DOI: 10.1007/s00277-023-05268-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2023] [Accepted: 05/07/2023] [Indexed: 05/18/2023]
Abstract
Therapy results in pediatric Hodgkin lymphoma reflect remarkable progress in pediatric oncology. In the last decade, relevant development of new therapeutic options for children with refractory or relapsed disease has been made. In this study, we retrospectively analyzed therapy results and risk factors in children treated in a single oncology center according to five therapeutic protocols. Data from 114 children treated by a single institution between 1997 and 2022 were analyzed. Classic Hodgkin lymphoma therapy results were divided into four therapeutic periods: 1997-2009, 2009-2014, 2014-2019, and 2019-2022. For nodular lymphocyte-predominant Hodgkin lymphoma, data from one therapeutic protocol was analyzed. For the entire group, the 5-year probability of overall survival was 93.5%. There were no statistically significant differences between therapeutic periods. The occurrence of B symptoms at diagnosis and incidence of relapse were risk factors for death (p = 0.018 and p < 0.001). Relapse occurred in 5 cases. The 5-year probability of relapse-free survival for the entire group was 95.2%, without significant differences between groups. Patients treated between 1997 and 2009 had over a sixfold higher risk for events, defined as primary progression, relapse, death, or incidence of secondary malignancies (OR = 6.25, p = 0.086). The 5-year probability of event-free survival for all patients was 91.3%. Five patients died, and the most common cause of death was relapse. Modern therapeutic protocols in pediatric Hodgkin lymphoma are marked by excellent outcomes. Patients with disease relapses have a notably high risk of death, and the development of new therapeutic options for this group remains one of the main goals of current trials.
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Affiliation(s)
- Joanna Stankiewicz
- Department of Pediatric Hematology and Oncology, Collegium Medicum, Nicolaus Copernicus University Toruń, Antoni Jurasz University Hospital No.1, Ul. Sklodowskiej-Curie 9, 85-094, Bydgoszcz, Poland.
| | - Andrzej Kołtan
- Department of Pediatric Hematology and Oncology, Collegium Medicum, Nicolaus Copernicus University Toruń, Antoni Jurasz University Hospital No.1, Ul. Sklodowskiej-Curie 9, 85-094, Bydgoszcz, Poland
| | - Ewa Demidowicz
- Department of Pediatric Hematology and Oncology, Collegium Medicum, Nicolaus Copernicus University Toruń, Antoni Jurasz University Hospital No.1, Ul. Sklodowskiej-Curie 9, 85-094, Bydgoszcz, Poland
| | - Natalia Bartoszewicz
- Department of Pediatric Hematology and Oncology, Collegium Medicum, Nicolaus Copernicus University Toruń, Antoni Jurasz University Hospital No.1, Ul. Sklodowskiej-Curie 9, 85-094, Bydgoszcz, Poland
| | - Sylwia Kołtan
- Department of Pediatric Hematology and Oncology, Collegium Medicum, Nicolaus Copernicus University Toruń, Antoni Jurasz University Hospital No.1, Ul. Sklodowskiej-Curie 9, 85-094, Bydgoszcz, Poland
| | - Krzysztof Czyżewski
- Department of Pediatric Hematology and Oncology, Collegium Medicum, Nicolaus Copernicus University Toruń, Antoni Jurasz University Hospital No.1, Ul. Sklodowskiej-Curie 9, 85-094, Bydgoszcz, Poland
| | - Monika Richert-Przygońska
- Department of Pediatric Hematology and Oncology, Collegium Medicum, Nicolaus Copernicus University Toruń, Antoni Jurasz University Hospital No.1, Ul. Sklodowskiej-Curie 9, 85-094, Bydgoszcz, Poland
| | - Robert Dębski
- Department of Pediatric Hematology and Oncology, Collegium Medicum, Nicolaus Copernicus University Toruń, Antoni Jurasz University Hospital No.1, Ul. Sklodowskiej-Curie 9, 85-094, Bydgoszcz, Poland
| | - Monika Pogorzała
- Department of Pediatric Hematology and Oncology, Collegium Medicum, Nicolaus Copernicus University Toruń, Antoni Jurasz University Hospital No.1, Ul. Sklodowskiej-Curie 9, 85-094, Bydgoszcz, Poland
| | - Barbara Tejza
- Department of Pediatric Hematology and Oncology, Collegium Medicum, Nicolaus Copernicus University Toruń, Antoni Jurasz University Hospital No.1, Ul. Sklodowskiej-Curie 9, 85-094, Bydgoszcz, Poland
| | - Joanna Cisek
- Department of Pediatric Hematology and Oncology, Collegium Medicum, Nicolaus Copernicus University Toruń, Antoni Jurasz University Hospital No.1, Ul. Sklodowskiej-Curie 9, 85-094, Bydgoszcz, Poland
| | - Piotr Księżniakiewicz
- Department of Pediatric Hematology and Oncology, Collegium Medicum, Nicolaus Copernicus University Toruń, Antoni Jurasz University Hospital No.1, Ul. Sklodowskiej-Curie 9, 85-094, Bydgoszcz, Poland
| | - Agnieszka Jatczak-Gaca
- Department of Pediatric Hematology and Oncology, Collegium Medicum, Nicolaus Copernicus University Toruń, Antoni Jurasz University Hospital No.1, Ul. Sklodowskiej-Curie 9, 85-094, Bydgoszcz, Poland
| | - Agata Marjańska
- Department of Pediatric Hematology and Oncology, Collegium Medicum, Nicolaus Copernicus University Toruń, Antoni Jurasz University Hospital No.1, Ul. Sklodowskiej-Curie 9, 85-094, Bydgoszcz, Poland
| | - Marlena Salamon
- Department of Pediatric Hematology and Oncology, Collegium Medicum, Nicolaus Copernicus University Toruń, Antoni Jurasz University Hospital No.1, Ul. Sklodowskiej-Curie 9, 85-094, Bydgoszcz, Poland
| | - Anna Dąbrowska
- Department of Pediatric Hematology and Oncology, Collegium Medicum, Nicolaus Copernicus University Toruń, Antoni Jurasz University Hospital No.1, Ul. Sklodowskiej-Curie 9, 85-094, Bydgoszcz, Poland
| | - Anna Urbańczyk
- Department of Pediatric Hematology and Oncology, Collegium Medicum, Nicolaus Copernicus University Toruń, Antoni Jurasz University Hospital No.1, Ul. Sklodowskiej-Curie 9, 85-094, Bydgoszcz, Poland
| | - Elżbieta Grześk
- Department of Pediatric Hematology and Oncology, Collegium Medicum, Nicolaus Copernicus University Toruń, Antoni Jurasz University Hospital No.1, Ul. Sklodowskiej-Curie 9, 85-094, Bydgoszcz, Poland
| | - Kamila Jaremek
- Department of Pediatric Hematology and Oncology, Collegium Medicum, Nicolaus Copernicus University Toruń, Antoni Jurasz University Hospital No.1, Ul. Sklodowskiej-Curie 9, 85-094, Bydgoszcz, Poland
| | - Monika Łęcka
- Department of Pediatric Hematology and Oncology, Collegium Medicum, Nicolaus Copernicus University Toruń, Antoni Jurasz University Hospital No.1, Ul. Sklodowskiej-Curie 9, 85-094, Bydgoszcz, Poland
| | - Oliwia Grochowska
- Department of Pediatric Hematology and Oncology, Collegium Medicum, Nicolaus Copernicus University Toruń, Antoni Jurasz University Hospital No.1, Ul. Sklodowskiej-Curie 9, 85-094, Bydgoszcz, Poland
| | - Jan Styczyński
- Department of Pediatric Hematology and Oncology, Collegium Medicum, Nicolaus Copernicus University Toruń, Antoni Jurasz University Hospital No.1, Ul. Sklodowskiej-Curie 9, 85-094, Bydgoszcz, Poland
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