Role of routine imaging in detecting recurrent lymphoma; a review of 258 patients with relapsed aggressive non-Hodgkin and Hodgkin lymphoma

Tarec Christoffer El-Galaly, Karen Juul Mylam, Martin Bøgsted, Peter De Nully Brown, Maria Rossing, Anne Ortved Gang, Anne Haglund, Bente Arboe, Michael Roost Clausen, Paw Jensen, Michael Pedersen, Anne Bukh, Bo Amdi Jensen, Christian Bjørn Poulsen, Francesco d'Amore, Martin Hutchings

Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

Resumé

After first-line therapy, patients with Hodgkin and aggressive non-Hodgkin lymphomas are followed closely for early signs of relapse. The current follow-up practice with frequent use of surveillance imaging is highly controversial and warrants a critical evaluation. Therefore a retrospective multicenter study of relapsed Hodgkin and aggressive non-Hodgkin lymphomas (nodal T-cell and diffuse large B-cell lymphomas) was conducted. All included patients had been diagnosed during the period 2002-2011 and relapsed after achieving complete remission on first-line therapy. Characteristics and outcome of imaging-detected relapses were compared to other relapses. A total of 258 patients with recurrent lymphoma were included in the study. Relapse investigations were initiated outside preplanned visits in 52% of the patients. Relapse detection could be attributed to patient-reported symptoms alone or in combination with abnormal blood tests or physical examination in 64% of the patients. Routine imaging prompted relapse investigations in 27% of the patients. The estimated number of routine scans per relapse was 91-255 depending on the lymphoma subtype. Patients with imaging-detected relapse had lower disease burden (P=.045) and reduced risk of death following relapse (hazard ratio 0.62, P=.02 in multivariate analysis). Patient reported symptoms are still the most common factor for detecting lymphoma relapse and the high number of scans per relapse calls for improved criteria for use of surveillance imaging. However, imaging-detected relapse was associated with lower disease burden and a possible survival advantage. The future role of routine surveillance imaging should be defined in a randomized trial.
OriginalsprogEngelsk
TidsskriftAmerican Journal of Hematology
Vol/bind89
Udgave nummer6
Sider (fra-til)575-580
ISSN0361-8609
DOI
StatusUdgivet - jun. 2014

Fingeraftryk

Hodgkin Disease
Non-Hodgkin's Lymphoma
Lymphoma
Lymphoma, Large B-Cell, Diffuse
Multicenter Studies
Physical Examination
Multivariate Analysis
Retrospective Studies

Citer dette

El-Galaly, T. C., Mylam, K. J., Bøgsted, M., Brown, P. D. N., Rossing, M., Gang, A. O., ... Hutchings, M. (2014). Role of routine imaging in detecting recurrent lymphoma; a review of 258 patients with relapsed aggressive non-Hodgkin and Hodgkin lymphoma. American Journal of Hematology, 89(6), 575-580. https://doi.org/10.1002/ajh.23688
El-Galaly, Tarec Christoffer ; Mylam, Karen Juul ; Bøgsted, Martin ; Brown, Peter De Nully ; Rossing, Maria ; Gang, Anne Ortved ; Haglund, Anne ; Arboe, Bente ; Clausen, Michael Roost ; Jensen, Paw ; Pedersen, Michael ; Bukh, Anne ; Jensen, Bo Amdi ; Poulsen, Christian Bjørn ; d'Amore, Francesco ; Hutchings, Martin. / Role of routine imaging in detecting recurrent lymphoma; a review of 258 patients with relapsed aggressive non-Hodgkin and Hodgkin lymphoma. I: American Journal of Hematology. 2014 ; Bind 89, Nr. 6. s. 575-580.
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abstract = "After first-line therapy, patients with Hodgkin and aggressive non-Hodgkin lymphomas are followed closely for early signs of relapse. The current follow-up practice with frequent use of surveillance imaging is highly controversial and warrants a critical evaluation. Therefore a retrospective multicenter study of relapsed Hodgkin and aggressive non-Hodgkin lymphomas (nodal T-cell and diffuse large B-cell lymphomas) was conducted. All included patients had been diagnosed during the period 2002-2011 and relapsed after achieving complete remission on first-line therapy. Characteristics and outcome of imaging-detected relapses were compared to other relapses. A total of 258 patients with recurrent lymphoma were included in the study. Relapse investigations were initiated outside preplanned visits in 52{\%} of the patients. Relapse detection could be attributed to patient-reported symptoms alone or in combination with abnormal blood tests or physical examination in 64{\%} of the patients. Routine imaging prompted relapse investigations in 27{\%} of the patients. The estimated number of routine scans per relapse was 91-255 depending on the lymphoma subtype. Patients with imaging-detected relapse had lower disease burden (P=.045) and reduced risk of death following relapse (hazard ratio 0.62, P=.02 in multivariate analysis). Patient reported symptoms are still the most common factor for detecting lymphoma relapse and the high number of scans per relapse calls for improved criteria for use of surveillance imaging. However, imaging-detected relapse was associated with lower disease burden and a possible survival advantage. The future role of routine surveillance imaging should be defined in a randomized trial.",
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month = "6",
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El-Galaly, TC, Mylam, KJ, Bøgsted, M, Brown, PDN, Rossing, M, Gang, AO, Haglund, A, Arboe, B, Clausen, MR, Jensen, P, Pedersen, M, Bukh, A, Jensen, BA, Poulsen, CB, d'Amore, F & Hutchings, M 2014, 'Role of routine imaging in detecting recurrent lymphoma; a review of 258 patients with relapsed aggressive non-Hodgkin and Hodgkin lymphoma', American Journal of Hematology, bind 89, nr. 6, s. 575-580. https://doi.org/10.1002/ajh.23688

Role of routine imaging in detecting recurrent lymphoma; a review of 258 patients with relapsed aggressive non-Hodgkin and Hodgkin lymphoma. / El-Galaly, Tarec Christoffer; Mylam, Karen Juul; Bøgsted, Martin; Brown, Peter De Nully; Rossing, Maria; Gang, Anne Ortved; Haglund, Anne; Arboe, Bente; Clausen, Michael Roost; Jensen, Paw; Pedersen, Michael; Bukh, Anne; Jensen, Bo Amdi; Poulsen, Christian Bjørn; d'Amore, Francesco; Hutchings, Martin.

I: American Journal of Hematology, Bind 89, Nr. 6, 06.2014, s. 575-580.

Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

TY - JOUR

T1 - Role of routine imaging in detecting recurrent lymphoma; a review of 258 patients with relapsed aggressive non-Hodgkin and Hodgkin lymphoma

AU - El-Galaly, Tarec Christoffer

AU - Mylam, Karen Juul

AU - Bøgsted, Martin

AU - Brown, Peter De Nully

AU - Rossing, Maria

AU - Gang, Anne Ortved

AU - Haglund, Anne

AU - Arboe, Bente

AU - Clausen, Michael Roost

AU - Jensen, Paw

AU - Pedersen, Michael

AU - Bukh, Anne

AU - Jensen, Bo Amdi

AU - Poulsen, Christian Bjørn

AU - d'Amore, Francesco

AU - Hutchings, Martin

N1 - Copyright © 2014 Wiley Periodicals, Inc., A Wiley Company.

PY - 2014/6

Y1 - 2014/6

N2 - After first-line therapy, patients with Hodgkin and aggressive non-Hodgkin lymphomas are followed closely for early signs of relapse. The current follow-up practice with frequent use of surveillance imaging is highly controversial and warrants a critical evaluation. Therefore a retrospective multicenter study of relapsed Hodgkin and aggressive non-Hodgkin lymphomas (nodal T-cell and diffuse large B-cell lymphomas) was conducted. All included patients had been diagnosed during the period 2002-2011 and relapsed after achieving complete remission on first-line therapy. Characteristics and outcome of imaging-detected relapses were compared to other relapses. A total of 258 patients with recurrent lymphoma were included in the study. Relapse investigations were initiated outside preplanned visits in 52% of the patients. Relapse detection could be attributed to patient-reported symptoms alone or in combination with abnormal blood tests or physical examination in 64% of the patients. Routine imaging prompted relapse investigations in 27% of the patients. The estimated number of routine scans per relapse was 91-255 depending on the lymphoma subtype. Patients with imaging-detected relapse had lower disease burden (P=.045) and reduced risk of death following relapse (hazard ratio 0.62, P=.02 in multivariate analysis). Patient reported symptoms are still the most common factor for detecting lymphoma relapse and the high number of scans per relapse calls for improved criteria for use of surveillance imaging. However, imaging-detected relapse was associated with lower disease burden and a possible survival advantage. The future role of routine surveillance imaging should be defined in a randomized trial.

AB - After first-line therapy, patients with Hodgkin and aggressive non-Hodgkin lymphomas are followed closely for early signs of relapse. The current follow-up practice with frequent use of surveillance imaging is highly controversial and warrants a critical evaluation. Therefore a retrospective multicenter study of relapsed Hodgkin and aggressive non-Hodgkin lymphomas (nodal T-cell and diffuse large B-cell lymphomas) was conducted. All included patients had been diagnosed during the period 2002-2011 and relapsed after achieving complete remission on first-line therapy. Characteristics and outcome of imaging-detected relapses were compared to other relapses. A total of 258 patients with recurrent lymphoma were included in the study. Relapse investigations were initiated outside preplanned visits in 52% of the patients. Relapse detection could be attributed to patient-reported symptoms alone or in combination with abnormal blood tests or physical examination in 64% of the patients. Routine imaging prompted relapse investigations in 27% of the patients. The estimated number of routine scans per relapse was 91-255 depending on the lymphoma subtype. Patients with imaging-detected relapse had lower disease burden (P=.045) and reduced risk of death following relapse (hazard ratio 0.62, P=.02 in multivariate analysis). Patient reported symptoms are still the most common factor for detecting lymphoma relapse and the high number of scans per relapse calls for improved criteria for use of surveillance imaging. However, imaging-detected relapse was associated with lower disease burden and a possible survival advantage. The future role of routine surveillance imaging should be defined in a randomized trial.

KW - Aged

KW - Hodgkin Disease/diagnosis

KW - Humans

KW - Lymphoma, Non-Hodgkin/diagnosis

KW - Middle Aged

KW - Neoplasm Recurrence, Local/diagnostic imaging

KW - Radiography

KW - Retrospective Studies

U2 - 10.1002/ajh.23688

DO - 10.1002/ajh.23688

M3 - Journal article

C2 - 24493389

VL - 89

SP - 575

EP - 580

JO - American Journal of Hematology

JF - American Journal of Hematology

SN - 0361-8609

IS - 6

ER -