Prognostic Impact of Pretransplantation Computed Tomography and Gallium Scans in Patients with Hodgkin Lymphoma with Poor Prognosis Undergoing Hematopoietic Stem Cell Transplantation

Abstract Background The present study evaluated computed tomography (CT) and Gallium-67 scanning ( 67 Ga) before transplantation as prognostic factors for overall survival (OS) and event-free survival (EFS) in patients with relapsed or primary refractory Hodgkin lymphoma undergoing high-dose chemotherapy and stem cell transplantation. Patients and Methods Forty-five patients were included. Of these, 10 (22%) had positive CT and 67 Ga scan results, 21 (47%) had negative results of both techniques, 12 (27%) had positive CT/negative 67 Ga scan results, and 2 (5%) had negative CT/positive 67 Ga scan results. Results Patients with positive CT/ 67 Ga scan results had a significantly worse EFS and OS at 5 years than those with negative 67 Ga scan results, whether it was associated with positive or negative CT scan results (0 and 25% vs. 83% and 90% vs. 74% and 83%, respectively; P 67 Ga scan results and those with positive CT/negative 67 Ga scan results, with an EFS and OS at 5 years of 74% vs. 83% and 83% vs. 90%, respectively. In multivariate analysis, the presence of pretransplantation positive CT/ 67 Ga scan results adversely influenced EFS and OS (hazard ratio, 39; 95% confidence interval, 8-202 [ P P Conclusion Gallium-67 scans help to identify pretransplantation CT-positive patients with a different outcome. A group of patients with positive CT/negative 67 Ga scan results before transplantation who showed a favorable outcome with a low rate of relapse and another group of patients with positive CT/ 67 Ga scan results before transplantation who showed poor prognosis did not benefit from autologous stem cell transplantation. They should be offered other therapeutic strategies.