Surveillance imaging in mantle cell lymphoma in first remission lacks clinical utility

• Type of Material: Article
• Authors: Daniel Guidot, Emory University; Jeffrey M. Switchenko, Emory University; Lorreta J. Nastoupil, University of Texas, Houston; Jean Louise Koff, Emory University; Kristie Blum, Emory University; Joseph Maly, Ohio State University; Christopher R Flowers, Emory University; Jonathon Cohen, Emory University
• Language: English
• Date: 2018-01-01
• Publisher: Taylor & Francis: STM, Behavioural Science and Public Health Titles
• Publication Version: Author Accepted Manuscript (After Peer Review)
• Copyright Statement: © 2017 Informa UK Limited, trading as Taylor & Francis Group.
• Final Published Version (URL): http://dx.doi.org/10.1080/10428194.2017.1361032
• Title of Journal or Parent Work: Leukemia & Lymphoma
• ISSN: 1042-8194
• Volume: 59
• Issue: 4
• Start Page: 888
• End Page: 895
• Grant/Funding Information: Research reported in this publication was supported in part by the Biostatistics and Bioinformatics Shared Resource of Winship Cancer Institute of Emory University and NIH/NCI under award number P30CA138292.; This study is supported in part by grants from the American Society of Hematology and Lymphoma Research Foundation (JBC).
• Keywords: FOLLOW-UP; TRANSPLANTATION; survival; Oncology; Life Sciences & Biomedicine; SURVIVAL; CT; Mantle cell lymphoma; Science & Technology; relapse; surveillance imaging; THERAPY; MCL2; Hematology; PET/CT; POSITRON-EMISSION-TOMOGRAPHY; DISEASE
• Research Categories: Health Sciences, Public Health; Health Sciences, Oncology

Abstract

Mantle cell lymphoma (MCL) is a heterogeneous disease with high relapse rates. Limited data guide the use of surveillance imaging following treatment. We constructed a retrospective cohort from two academic institutions of patients with MCL who completed first-line therapy and underwent follow-up for relapse, analyzing the effect of surveillance imaging on survival. Of 217 patients, 102 had documented relapse, with 38 (37%) diagnosed by surveillance imaging and 64 (63%) by other methods. Relapse diagnosis by surveillance imaging had no significant advantage in overall survival from diagnosis date (hazard ratio [HR] = 0.80, p = .39) or relapse date (HR = 0.72, p = .22). Of 801 surveillance images, PET/CT had a positive predictive value (PPV) of 24% and number needed-to-scan/treat (NNT) of 51 to detect one relapse, and CT had a PPV of 49% and NNT of 24. For MCL after first-line therapy, relapse detection by surveillance imaging was not associated with improved survival and lacks clinical benefit.