Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0019829 (Hodgkin's disease)
 30,247 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Yttrium-90 ibritumomab tiuxetan (Zevalin; IDEC Pharmaceuticals Corp., San Diego, CA) is the first radioimmunotherapy agent approved by the U.S. Food and Drug Administration (FDA) for treatment of non-Hodgkin lymphoma. In a randomized clinical trial comparing Zevalin with rituximab, the overall response rate was 80% and 56%, respectively. Response was determined by assessing the size of lymph nodes on CT scans. FDG PET has been well accepted as an accurate imaging study for staging non-Hodgkin lymphoma and evaluating response to treatment. Simultaneous FDG PET and CT imaging (PET CT) provides coregistered functional PET images with anatomic CT images. We describe 2 cases of non-Hodgkin lymphoma treated in which response was followed using PET CT.
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PMID:FDG PET CT assessment of treatment response after yttrium-90 ibritumomab tiuxetan radioimmunotherapy. 1602 58

In Hodgkin's lymphoma (HL), PET imaging should be performed in all patients, particularly in stage I or II disease where change in staging will alter management. For aggressive Non-Hodgkin's lymphoma (NHL), PET imaging is valuable to provide a baseline for response evaluation. For indolent NHL, it is concluded that PET imaging is not generally indicated. For HL, a negative FDG-PET scan is highly indicative of long-term, disease-free survival and is particularly useful in the presence of residual CT mass. For aggressive NHL, a positive FDG-PET scan is predictive of disease persistence or recurrence. There is a significant incidence of false-negative FDG-PET scans, which in most cases means minimal residual disease that cannot be detected by the current instrumentation. For both NHL and aggressive HL, early assessment of response appears to be predictive of long-term outcome. Optimal time of FDG-PET scan during therapy needs to be determined. For indolent NHL, the high rate of false-negative FDG-PET scans raises questions to its clinical role in response evaluation. FDG-PET and PET-CT improve primary staging and restaging of lymphomas. Metabolic imaging will be the standard technology for assessment of therapy with documented prognostic value. Imaging during therapy may be valuable to individualize therapeutic protocols and to define chemosensitivity of tumor tissue. Minimal residual disease cannot be detected with current imaging devices.
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PMID:Role of PET in lymphoma. 1608 46

Risk-adapted lymphoma treatment requires early and accurate assessment of prognosis. This investigation prospectively assessed the value of positron emission tomography with 2-[18F]fluoro-2-deoxy-D-glucose (FDG-PET) after two cycles of chemotherapy for prediction of progression-free survival (PFS) and overall survival (OS) in Hodgkin lymphoma (HL). Seventy-seven consecutive, newly diagnosed patients underwent FDG-PET at staging, after two and four cycles of chemotherapy, and after completion of chemotherapy. Median follow-up was 23 months. After two cycles of chemotherapy, 61 patients had negative FDG-PET scans and 16 patients had positive scans. Eleven of 16 FDG-PET-positive patients progressed and 2 died. Three of 61 FDG-PET-negative patients progressed; all were alive at latest follow-up. Survival analyses showed strong associations between early FDG-PET after two cycles and PFS (P < .001) and OS (P < .01). For prediction of PFS, interim FDG-PET was as accurate after two cycles as later during treatment and superior to computerized tomography (CT) at all times. In regression analyses, early interim FDG-PET was stronger than established prognostic factors. Other significant prognostic factors were stage and extranodal disease. Early interim FDG-PET is a strong and independent predictor of PFS in HL. A positive early interim FDG-PET is highly predictive of progression in patients with advanced-stage or extranodal disease.
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PMID:FDG-PET after two cycles of chemotherapy predicts treatment failure and progression-free survival in Hodgkin lymphoma. 1615 Sep 44

In patients with Hodgkin's lymphoma (HL) at the end of first line therapy an accurate imaging technique with high prognostic value is needed to assess response to treatment and predict those patients who will suffer disease relapse. This technique and its results permit the quick initiation of a second line therapy in patients suffering from a progressive disease or those unresponsive to treatment avoid over-treatment of patients in complete remission or those having a non-active residual disease. We included a (18)FDG-positron emission tomography (PET) scan to the diagnostic set-up to investigate 28 patients following the end of their treatment. Fifteen patients out of the 28 (54%) had positive CT scans while 13 (46%) had negative ones. Eleven patients out of the 15 CT positive (73%) had negative PET scans and no relapse. The remaining four patients (27%) had positive PET scans with only one relapse (25%). With respect to the 13 patients who had negative CT scans, 9 patients (69%) had negative PET scans and no relapse. The remaining 4 patients (31%) had positive PET scans with 3 relapse cases (75%). In our final assessment after a median follow-up period of 45 months, starting from PET execution to the last follow-up, overall sensitivity of the CT and the PET were 25 and 100% respectively, specificity 42 and 83% respectively, positive predictive value (PPV) 7 and 50% respectively, negative predictive value (NPV) 77 and 100% respectively, and accuracy 39 and 86% respectively. In our experience, FDG-PET performed in patients after induction therapy appears to offer important additional information: FDG-PET results are predictors of prognosis giving 100% DFS in PET negative patients and 54% DSF in PET positive patients.
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PMID:18FDG-positron emission tomography in post treatment evaluation of residual mass in Hodgkin's lymphoma: long-term results. 1621 Dec 87

In two women with Hodgkin's disease, 36 and 34 years of age, the PET-scan showed increased FDG-uptake in regions where the CT-scan did not reveal any abnormalities. Integration of the PET-CT images visualised bone marrow localisations in both patients. One patient underwent a CT-guided bone biopsy that confirmed this localisation. In both cases, the results of the integrated PET-CT images altered the therapy that would have been given on the basis ofthe standard staging technique. Both patients underwent radiotherapy. After 6 months, one patient had no visible lesions. The other patient died due to progression ofthe disease. Integrated PET-CT images can play an important role, not only in the precise classification and staging of lymphoma but also at the start of therapy, as an initial scan, in the evaluation of the response to treatment, and in the early detection of recurrence.
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PMID:[The value of integrated PET-CT images in 2 lymphoma patients with skeletal localisations]. 1647 Dec 37

Despite the increasing number of publications concerning 18F-fluorodeoxyglucose positron emission tomography (FDG-PET) for post-treatment evaluation of lymphoma and the increasing availability of this novel diagnostic modality, its exact role in response assessment after therapy is still unknown. The aim of this study was to systematically review the literature regarding the diagnostic performance of dedicated FDG-PET in evaluation of first-line therapy of Hodgkin's disease and (aggressive) non-Hodgkin's lymphoma, and to calculate summary estimates of its sensitivity and specificity. The databases of PubMed and Embase were searched for relevant studies up to January 2004. Two reviewers independently assessed the methodological quality of each study. As a valid reference test, histology or follow-up of at least 12 months were accepted. A meta-analysis of the reported sensitivity and specificity of each study was performed. Fifteen studies, involving 705 patients, met the inclusion criteria. The studies had several design deficiencies. The majority of studies did not describe whether the reference test was interpreted without knowledge of the FDG-PET findings. In all studies, there was a description of the spectrum of patients included, i.e. all patients for post-treatment evaluation or only patients with substantial residual masses post-treatment. Pooled sensitivity and specificity for detection of residual disease in Hodgkin's lymphoma were 84% (95% CI 71-9192%) and 90% (95% CI 84-9394%), respectively. For non-Hodgkin's lymphoma, pooled sensitivity and specificity were 72% (95% CI 61-82%), and 100% (95% CI 97-100%), respectively. FDG-PET showed reasonable sensitivity and high specificity for evaluation of first-line therapy in Hodgkin's and in non-Hodgkin's lymphoma. Standardization of procedures is required before implementation in clinical practice.
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PMID:18F-fluoro-deoxyglucose positron emission tomography for post-treatment evaluation of malignant lymphoma: a systematic review. 1658 17

Positron emission tomography using 2-[18F]fluoro-2-deoxy-D-glucose (FDG-PET) enables quantitative analysis of metabolic activity. This study investigated standardized uptake value (SUV) levels in the different histopathological subtypes of Hodgkin lymphoma (HL). Sixty patients with newly diagnosed HL underwent staging FDG-PET/CT after lymph node biopsy. Maximum SUV in each patient (SUV(max/total)) and in each affected region or organ (SUV(max)) were recorded. Mean SUV(max/total) was 9.3 g/ml in seven nodular lymphocyte predominance (NLP) patients, 16.3 g/ml in 38 nodular sclerosis (NS) patients, 20.8 g/ml in 11 mixed cellularity (MC) patients, and 19.5 g/ml in four patients with unclassified classical HL (CHL-NOS), (ANOVA, p = 0.011). Out of 780 sites (600 lymph node regions plus 180 organs), 208 sites were found to be affected with HL. Mean SUV(max) was 8.3 g/ml in the 12 sites with NLP, 11.2 g/ml in the 147 sites affected with NS, 14.6 g/ml in the 36 sites with MC, and 13.1 g/ml in the 13 sites with CHL-NOS (ANOVA, p = 0.002). There is a significant difference in FDG/glucose uptake between the different histopathological subtypes of HL.
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PMID:Different histopathological subtypes of Hodgkin lymphoma show significantly different levels of FDG uptake. 1672 53

We conducted a retrospective analysis of 50 lymphoma patients (Hodgkin's disease and non-Hodgkin's lymphoma) who had an 18F-fluoro-deoxyglucose positron emission tomography (FDG-PET) scan after at least two cycles of salvage chemotherapy and before autologous stem cell transplantation (ASCT) at our institution. The patients were categorized into FDG-PET negative (N = 32) and positive (N = 18) groups. The median follow-up after ASCT was 19 months (range: 3-59). In the FDG-PET-negative group, the median progression-free survival (PFS) was 19 months (range: 2-59) with 15 (54%) patients without progression at 12 months after ASCT. The median overall survival (OS) for this group was not reached. In the FDG-PET-positive group, the median PFS was 5 months (range: 1-19) with only one (7%) patient without progression at 12 months after ASCT. The median OS was 19 months (range: 1-34). In the FDG-PET-negative group, chemotherapy-resistant patients by CT-based criteria had a comparable outcome to those with chemotherapy-sensitive disease. A positive FDG-PET scan after salvage chemotherapy and prior ASCT indicates an extremely poor chance of durable response after ASCT.
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PMID:Prognostic value of FDG-PET scan imaging in lymphoma patients undergoing autologous stem cell transplantation. 1677 Mar 14

Positron emission tomography using F-flurodeoxyglucose (FDG-PET) is considered an excellent tool for staging and monitoring disease status in adults with lymphoma. We retrospectively reviewed results of PET/CT and diagnostic computed tomography (CT) scans performed during follow-up after completion of therapy in 41 children <18 years of age with Hodgkin lymphoma and non-Hodgkin lymphoma. PET/CT scan with uptake greater than that of the liver was considered positive. Uptake that increased over the background but less than in the liver was equivocal. Clinical outcomes were obtained from medical records. Thirteen (32%) had a positive PET/CT scan and an equal number had equivocal scans in a median follow-up of 2.3 years. Diagnostic CT scans revealed new findings in 13 (32%) and persistent abnormalities in 21 (51%) of the children. Five children developed recurrent disease, and one developed a second cancer. No children with equivocal positivity developed recurrent disease. PET/CT scan was 95% sensitive, with a positive predictive value (PPV) of 53%. Diagnostic CT was 79% sensitive, with a PPV of 52%. We conclude that a negative PET/CT scan during routine follow-up for lymphoma in children strongly suggests absence of recurrence but a positive PET/CT and diagnostic CT scans have low PPV and should be interpreted with caution in this setting.
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PMID:Utility of FDG-PET/CT in follow-up of children treated for Hodgkin and non-Hodgkin lymphoma. 1677 81

Early therapy response assessment with metabolic imaging is potentially useful to determine prognosis in aggressive lymphoma and, thus, can guide first-line therapy. Forty-eight patients with aggressive lymphoma [24 Hodgkin's disease (HD); 24 non-Hodgkin's lymphoma (NHL)] underwent fluoro-deoxyglucose positron emission tomography (FDG-PET) before chemotherapy (PET1) and at mid-treatment (PET2). Therapeutic response was evaluated using conventional methods at mid-treatment. PET2 results were related to event-free survival (EFS) and overall survival (OS) using Kaplan-Meier analyses. PET1 was positive in all patients. PET2 was negative in 38 patients (18 NHL-20 HD) and positive in 10 (6 NHL-4 HD). Of the PET-negative patients, 61 and 65% achieved complete remission, and only 50 and 25% of PET-positive patients, respectively, for NHL and HD, achieved complete remission. Significant associations were found between PET2 and EFS (p = 0.0006) and OS (p = 0.04) for NHL, and EFS (p < 0.0001) for HD (but not for OS, because no HD patient died). FDG-PET at mid-treatment can predict the outcome of patients with aggressive lymphoma and should be a useful tool to modify an ineffective therapy.
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PMID:FDG-PET/CT predicts outcome in patients with aggressive non-Hodgkin's lymphoma and Hodgkin's disease. 1687 91


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