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. 2014 Nov 1;32(31):3506-12.
doi: 10.1200/JCO.2014.55.7561. Epub 2014 Sep 29.

Utility of routine post-therapy surveillance imaging in diffuse large B-cell lymphoma

Carrie A Thompson  1 , Herve Ghesquieres  2 , Matthew J Maurer  2 , James R Cerhan  2 , Pierre Biron  2 , Stephen M Ansell  2 , Catherine Chassagne-Clément  2 , David J Inwards  2 , Thérèse Gargi  2 , Patrick B Johnston  2 , Emmanuelle Nicolas-Virelizier  2 , William R Macon  2 , Marie Peix  2 , Ivana N Micallef  2 , Catherine Sebban  2 , Grzegorz S Nowakowski  2 , Luis F Porrata  2 , George J Weiner  2 , Thomas E Witzig  2 , Thomas M Habermann  2 , Brian K Link  2
Affiliations

Utility of routine post-therapy surveillance imaging in diffuse large B-cell lymphoma

Carrie A Thompson et al. J Clin Oncol. .

Abstract

Purpose: We examined the utility of post-therapy surveillance imaging in a large, prospectively enrolled cohort of patients with diffuse large B-cell lymphoma (DLBCL) from the United States and confirmed our results in an independent cohort of patients from France.

Methods: Patients with newly diagnosed DLBCL and treated with anthracycline-based immunochemotherapy were identified from the Molecular Epidemiology Resource (MER) of the University of Iowa/Mayo Clinic Lymphoma Specialized Program of Research Excellence and the Léon Bérard Cancer Center, Lyon, France. In those with relapse, details at relapse and outcomes were abstracted from records.

Results: 680 individuals with DLBCL were identified from the MER, 552 (81%) of whom achieved remission after induction. 112 of the 552 patients (20%) suffered a relapse. The majority (64%) of relapses were identified before a scheduled follow-up visit. Surveillance imaging detected DLBCL relapse before clinical manifestations in nine out of 552 patients (1.6%) observed after therapy. In the Lyon cohort, imaging identified asymptomatic DLBCL relapse in four out of 222 patients (1.8%). There was no difference in survival after DLBCL relapse in patients detected at scheduled follow-up versus before scheduled follow-up in both the MER (P = .56) and Lyon cohorts (P = .25).

Conclusion: The majority of DLBCL relapses are detected outside of planned follow-up, with no difference in outcome in patients with DLBCL detected at a scheduled visit compared with patients with relapse detected outside of planned follow-up. These data do not support the use of routine surveillance imaging for follow-up of DLBCL.

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Figures

Fig 1.
Fig 1.
(A) Molecular Epidemiology Resource (MER) cohort flowchart. (B) Lyon cohort flowchart. DLBCL, diffuse large B-cell lymphoma.
Fig 2.
Fig 2.
(A) Overall survival of 112 patients with relapsed diffuse large B-cell lymphoma (DLBCL) from Molecular Epidemiology Resource cohort. (B) Overall survival of 55 patients with relapsed DLBCL from Lyon cohort.
Fig 3.
Fig 3.
(A) Flowchart of 112 patients with relapsed diffuse large B-cell lymphoma (DLBCL) from Molecular Epidemiology Resource (MER) cohort. (B) Flowchart of 55 patients with relapsed DLBCL from Lyon cohort.
Fig 4.
Fig 4.
Clinical features at relapse detection in 104 Molecular Epidemiology Resource (MER) patients and 55 Lyon patients with diffuse large B-cell lymphoma with post-therapy relapse, regardless of timing of relapse. LDH, lactate dehydrogenase.
Fig A1.
Fig A1.
(A) Cumulative incidence of events in Molecular Epidemiology Resource cohort of 552 newly diagnosed patients with diffuse large B-cell lymphoma (DLBCL) entering surveillance. (B) Cumulative incidence of events in Lyon cohort of 222 newly diagnosed patients with DLBCL entering surveillance.
Fig A2.
Fig A2.
Flowchart in patients followed at Mayo Clinic or University of Iowa. DLBCL, diffuse large B-cell lymphoma.
See this image and copyright information in PMC

Comment in

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