In a nutshell
This study looked at the effect of surveillance scans after autologous stem cell transplantation (auto-SCT) in patients with relapsed or refractory diffuse large B-cell lymphoma. The study concluded that scanning everyone after auto-SCT has little benefit.
Some background
Diffuse large B-cell lymphoma (DLBCL) is the most common type of non-Hodgkin lymphoma. DLBCL generally has good response rates. However, some patients will relapse or not respond to initial treatment (refractory). The standard of care for patients with relapsed or refractory DLBCL is auto-SC (using stem cells from the patient’s own body).
After auto-SCT, patients get routine scans (PET or CT scans) to see if their cancer has come back. Recently, however, some have questioned whether surveillance PET or CT scans are beneficial. Increased numbers of PET or CT scans also increases the risk of developing a secondary cancer because of the radiation emitted during the scan.
Methods & findings
The medical records of 139 patients were reviewed. All patients had relapsed or refractory DLBCL and received auto-SCT. 37 patients relapsed after auto-SCT. 21 relapses (57%) were detected clinically by the doctor based on patient symptoms. 16 relapses (43%) were detected during a surveillance scan. The average length of follow up was 587 days for clinically relapsed patients and 1503 days for patients diagnosed with a PET or CT scan.
The progression free survival (time from treatment to disease progression) was 167 days for the clinically diagnosed group. The progression free survival was 565 days for the group diagnosed with a PET or CT scan. This difference was statistically significant.
The average survival time from relapse onwards was 178 days for clinically diagnosed patients and 1211 days for patients diagnosed with a PET or CT scan. Patients diagnosed clinically had more aggressive cancer that was able to be detected through patient symptoms.
The survival outcomes for patients with aggressive disease did not change whether they were diagnosed clinically or with a PET or CT scan.
The bottom line
The authors concluded that there is little benefit to screening everyone after they receive an autologous stem cell transplantation.
Published By :
Hematology/oncology and stem cell therapy
Date :
Dec 19, 2017
