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. 2021 Sep 26;10(19):4396.
doi: 10.3390/jcm10194396.

Total Lesion Glycolysis Improves Tumor Burden Evaluation and Risk Assessment at Diagnosis in Hodgkin Lymphoma

Ines Herraez  1   2 , Leyre Bento  2   3 , Jaume Daumal  2   4 , Alessandra Repetto  2   4 , Raquel Del Campo  1   2 , Sandra Perez  2   3 , Rafael Ramos  2   5 , Javier Ibarra  2   6 , Francesc Mestre  2   7 , Joan Bargay  1   2 , Paloma Lopez  2   8 , Joan Garcias-Ladaria  2   9 , Antonia Sampol  2   3 , Antonio Gutierrez  2   3
Affiliations

Total Lesion Glycolysis Improves Tumor Burden Evaluation and Risk Assessment at Diagnosis in Hodgkin Lymphoma

Ines Herraez et al. J Clin Med. .

Abstract

Hodgkin lymphoma (HL) is a hematological malignancy with an excellent prognosis. However, we still need to identify those patients that could experience failed standard frontline chemotherapy. Tumor burden evaluation and standard decisions are based on Ann Arbor (AA) staging, but this approach may be insufficient in predicting outcomes. We aim to study new ways to assess tumor burden through volume-based PET parameters to improve the risk assessment of HL patients. We retrospectively analyzed 101 patients with HL from two hospitals in the Balearic Islands between 2011 and 2018. Higher metabolic tumor volume (MTV) and total lesion glycolysis (TLG) were significantly associated with a higher incidence of III-IV AA stages, B-symptoms, hypoalbuminemia, lymphopenia, and higher IPS. Standardized uptake value (SUVmax) was significantly related to AA stage and hypoalbuminemia. We found that TLG or the combination of SUVmax, TLG, and MTV significantly improved the risk assessment when compared to AA staging. We conclude that TLG is the best single PET/CT-related tumor-load parameter that significantly improves HL risk assessment when compared to AA staging. If confirmed in a larger and validated sample, this information could be used to modify standard frontline therapy and justifies the inclusion of TLG inside an HL prognostic score.

Keywords: Ann Arbor stage; Hodgkin lymphoma; metabolic tumor volume; risk assessment; survival; total lesion glycolysis.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Impact on PFS of standard and PET/CT-related tumor-load assessments. (A) PFS of the whole series; (B) PFS according to AA staging; (C) PFS according to MTV; (D) PFS according to TLG; (E) PFS according to SUVmax; (F) PFS according to all three PET/CT metrics.
Figure 2
Figure 2
Impact on PFS of GHSG and PET/CT-related tumor-load assessments in I–II AA stages. (A) PFS according to TLG; (B) PFS according to all three PET/CT metrics; (C) PFS according to MTV; (D) PFS according to GHSG at diagnosis.
See this image and copyright information in PMC

References

    1. Lister T.A., Crowther D., Sutcliffe S.B., Glatstein E., Canellos G.P., Young R.C., Rosenberg S.A., Coltman C.A., Tubiana M. Report of a committee convened to discuss the evaluation and staging of patients with Hodgkin’s disease: Cotswolds meeting. J. Clin. Oncol. 1989;7:1630–1636. doi: 10.1200/JCO.1989.7.11.1630. - DOI - PubMed
    1. Cheson B.D., Fisher R.I., Barrington S.F., Cavalli F., Schwartz L.H., Zucca E., Lister T.A. Recommendations for initial evaluation, staging, and response assessment of hodgkin and non-hodgkin lymphoma: The lugano classification. J. Clin. Oncol. 2014;32:3059–3068. doi: 10.1200/JCO.2013.54.8800. - DOI - PMC - PubMed
    1. Song M.K., Chung J.S., Shin H.J., Lee S.M., Lee S.E., Lee H.S., Lee G.W., Kim S.J., Lee S.M., Chung D.S. Clinical significance of metabolic tumor volume by PET/CT in stages II and III of diffuse large B cell lymphoma without extranodal site involvement. Ann. Hematol. 2012;91:697–703. doi: 10.1007/s00277-011-1357-2. - DOI - PMC - PubMed
    1. Cheson B.D. Role of Functional Imaging in the Management of Lymphoma. J. Clin. Oncol. 2011;29:1844–1854. doi: 10.1200/JCO.2010.32.5225. - DOI - PubMed
    1. Kostakoglu L., Chauvie S. Metabolic Tumor Volume Metrics in Lymphoma. Semin. Nucl. Med. 2018;48:50–66. doi: 10.1053/j.semnuclmed.2017.09.005. - DOI - PubMed

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