TY - JOUR
T1 - Surveillance imaging in mantle cell lymphoma in first remission lacks clinical utility
AU - Guidot, Daniel M.
AU - Switchenko, Jeffrey M.
AU - Nastoupil, Loretta J.
AU - Koff, Jean L.
AU - Blum, Kristie A.
AU - Maly, Joseph
AU - Flowers, Christopher R.
AU - Cohen, Jonathon B.
N1 - Publisher Copyright:
© 2017 Informa UK Limited, trading as Taylor & Francis Group.
PY - 2018/8/11
Y1 - 2018/8/11
N2 - 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.
AB - 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.
KW - CT
KW - Mantle cell lymphoma
KW - PET/CT
KW - Relapse
KW - Surveillance imaging
KW - Survival
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U2 - 10.1080/10428194.2017.1361032
DO - 10.1080/10428194.2017.1361032
M3 - Article
C2 - 28797213
AN - SCOPUS:85027323973
SN - 1042-8194
VL - 59
SP - 888
EP - 895
JO - Leukemia and Lymphoma
JF - Leukemia and Lymphoma
IS - 4
ER -